Worry  w 
Nervousness 

or  the  science 
of  Self-Mastery 


WilliaraS.SallecM.D. 


I 


EM  ME/AORIAIA 
Charles   Josselyn. 


i 


WORRY  AND  NERVOUSNESS 


BOOKS  BY  DR.   SADLER 


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w 


FIG.  i. 

THE  SYMPATHETIC  NERVOUS  SYSTEM 
(The  Mischief-Making  Mechanism) 


WORRY  and  NERVOUSNESS 

OR 

THE  SCIENCE  OF  SELF-MASTERY 

BY 

WILLIAM  S.  SADLER,  M.  D. 


PROFESSOR    OF  THERAPEUTICS,    THE    POST-GRADUATE    MEDICAL    SCHOOL    OF    CHICAGO  ; 
DIRECTOR     OF     THE     CHICAGO    INSTITUTE     OF     PHYSIOLOGIC     THERAPEUTICS  I 
FELLOW    OF   THE    AMERICAN    MEDICAL  ASSOCIATION  I    MEMBER  OF   THE 
CHICAGO   MEDICAL    SOCIETY  i      THE    ILLINOIS    STATE    MEDICAL 
SOCIETY  ;       THE     PRESS    CLUB       OF      CHICAGO  J       THE 
AMERICAN  ASSOCIATION    FOR  THE   ADVANCE- 
MENT     OF       SCIENCE,      ETC.,      ETC. 


ILLUSTRATED 


CHICAGO 
A.  C.  McCLURG  &  CO. 
1914 


615955 


BIOLOGY 

LIBRARY 

G 


Copyright 

A.  C.  McCLURG  &  CO. 

1914 


Published  October,  1914 


Ccpyrighttd  in  Great  Britain 


I.  f.  Sail  Jfrintutg  (La..  Chtraga 


TO 

ALL   MY  "NERVE" 
PATIENTS:    TO  THOSE  SUFFERERS  FROM 
FUNCTIONAL   NERVOUS  DISTURBANCES,  WHO  HAVE  BEEN  HELPED  BY 
THE  ADVICE  HEREIN   CONTAINED- AND  WHO  HAVE  THUS 
INSPIRED   ME  TO  PUT  FORTH  RENEWED   EF- 
FORTS TO  HELP  OTHERS  — THIS  BOOK 
IS  AFFECTIONATELY 
DEDICATED 


PREFACE 

SIN'CE  the  appearance  of  The  Physiology  of  Faith  and  Fear 
a  few  years  ago,  I  have  been  importuned  on  many  occasions 
to  undertake  the  preparation  of  a  work  devoted  more  fully  to 
concise  and  systematic  directions  regarding  the  treatment  and 
management  of  the  various  "nervous  states;  "  and  this  present 
volume  represents  my  efforts  to  comply  with  this  demand,  which 
has  been  so  insistent  on  the  part  of  both  the  laity  and  the  pro- 
fession. 

Having  dealt  quite  fully  with  the  Physiological  and  Psycho- 
logical phases  of  functional  nervous  disorders  in  the  former 
work,  this  book  will  be  almost  exclusively  devoted  to  an  ampli- 
fication of  the  therapeutics  —  the  details  of  treatment  and  the 
practical  management  of  the  various  neuroses,  including  a  large 
group  of  "  borderland  "  ailments  such  as  alcoholism,  migraine, 
chorea,  etc. 

The  methods  herein  described  are  those  practiced  in  the  daily 
management  of  these  various  "  nervous  disorders,"  whether  met 
in  the  clinic,  the  hospital,  or  in  the  private  consulting  room; 
and  in  this  connection  the  author  desires  to  reiterate  a  state- 
ment made  in  the  preface  of  his  former  work,  viz.,  that  he 
makes  no  pretensions  of  being  a  professional  psychotherapist  — 
that  his  time  and  energies  are  largely  devoted  to  other  pro- 
fessional duties. 

It  was  the  experience  of  seeing  so  many  "  nervous  "  patients 
who  had  been  neglected,  operated  upon,  and  otherwise  mistreated, 
without  being  in  the  least  helped;  and  the  further  experience 
of  seeing  a  large  number  of  these  unfortunate  sufferers  more 
or  less  permanently  cured  at  the  hands  of  the  numerous  psychic 
cults  and  mind  cure  "'  isms,"  that  led  to  the  further  study  and 
examination    of    the    science   of    psychotherapy,    all    of    which 


viii  PREFACE 

culminated  in  the  writing  of  The  Physiology  of  Faith  and  Fear, 
and  in  the  preparation  of  this  volume. 

It  has  been  my  experience  that  Neurasthenics  get  little  help 
from  simply  reading  a  book  through  a  single  time ;  they  should 
read  and  re-read  —  study  —  this  book  systematically,  say  one 
hour  every  day,  until  its  teachings  become  a  real  part  of  their 
mental  life. 

While  I  am  greatly  indebted  to  the  psychotherapeutic  litera- 
ture of  the  day  —  from  which  I  have  freely  drawn  material  for 
this  volume  —  nevertheless,  I  desire,  in  a  special  manner,  to 
acknowledge  the  help  and  inspiration  which  have  come  from 
the  work  and  works  of  such  original  and  pioneer  workers  as 
Janet,  Forel,  Prince,  Breuer,  and  Dubois  —  men  who  have  done 
so  much  to  lead  the  way  out  from  the  older  empiric  and  hypnotic 
notions  of  mind  cure  into  the  vast  and  verdant  pastures  of  mod- 
ern suggestional  and  educational  psychotherapeutics. 

I  am  especially  indebted  to  Dr.  W.  A.  Evans  for  his  reading 
of  the  manuscript  and  valuable  suggestions,  especially  the  one 
which  led  to  the  writing  of  Chapter  xxvn  on  "  Decision  De- 
velopment." I  am  also  indebted  to  Dr.  Julius  Grinker  for  his 
criticism  and  suggestions  with  reference  to  Chapter  xxvin 
"  The  Relief  of  Repressed  Emotions." 

It  is  the  Author's  sincere  hope  that  this  work,  whether  fall- 
ing accidentally  into  the  hands  of  the  laity  —  especially  nervous 
sufferers  —  or  whether  put  there  by  the  physician,  will  contribute 
something  definite  to  the  emancipation  of  such  sufferers  from 
the  tyranny  of  "  nerves,"  the  slavery  of  "  worry,"  and  the  thral- 
dom of  "  fear." 

William  S.  Sadler. 
32  N.  State  Street,  Chicago, 
October  1,  1914. 


CONTENTS 


PART  I 

A  STUDY  OF  THE  NERVOUS  STATES 
CHAPTER 

I     Seven  Sorts  of  Nervousness 
II     Heredity  and  Environment  as  Neurasthenic 
Factors 

III  Influence  of  the  Physical  Health  on  the  Mind 

IV  Power  of  the  Mind  over  the  Body     . 
V     Chronic  Fear,  or  Common  Worry 

VI  Common  Causes  of  Worry  and  Nervousness 

VII  Habit  Tension  of  Mind  and  Body 

VIII  Crystalized  Fear  and  Definite  Dreads 

IX  "  Americanitis,"  or  the  High  Pressure  Life 

X  Neurasthenoidia,    or    Near-Neurasthenia 

XI  Neurasthenia,  or  Nervous  Exhaustion     . 

XII  The  Causes  of  Neurasthenia 

XIII  The  Ear-Marks  of  Neurasthenia 

XIV  Fastidious  Suffering  and  Imaginary  Pain 
XV  The  Mission  of  Suffering  and  the   Purpose 

of    Pain 

XVI     Special    Forms    of    Neurasthenia 
XVII     Psychasthenia,  or  True  Brain  Fag 
XVIII     Hysteria,  the  Master  Imitator     . 
XIX     Hypochondria  and   Melancholia 
XX     Border   Land   Nervous  Ailments 

PART  II 

TREATMENT  OF  THE  NERVOUS  STATES 

XXI  The  General  Hygiene  of  the  Nervous  System 

XXII  Modern    Psychotherapy  —  Mental    Medicine 

XXIII  Pseudo-Psychotherapy  —  Mental    Deception 

XXIV  The  Art  of  Therapeutic  Suggestion 


PAGE 

3 

ii 

22 

33 

5i 
63 
80 

95 
107 
120 
128 
143 
159 
1/4 

188 
201 
210 
221 
235 
243 


255 
275 
286 
300 


CONTEXTS 


CHAPTER  PAG9 

XXV     Educational    Therapeutics 316 

XXVI  The   Exaltation   of  the   Will       ....  329 

XXVII     Decision  Development 342 

XXVIII  The  Relief  of  Repressed  Emotions     ...  351 

XXIX     Recreation   and   Relaxation 371 

XXX  The  Physical  Treatment  of  the  Neurasthenic 

States 392 

XXXI     Stimulants  and  Narcotics 410 

XXXII  The  Writing  or  Elimination  Cure     .       .       .  424 

XXXIII  The  Study  or  Substitution  Cure       .       .       .  445 

XXXIV  The  Rest  or  Play  Cure 458 

XXXV  The  Work  or  Occupation  Cure         .       .       .  469 

XXXVI     The  Social   Service  Cure 480 

XXXVII  The   Faith   and  Prayer  Cure       ....  488 

XXXVIII     Triumphant  Self-Mastery 504 


LIST  OF  PLATES 


FIGURE  PAGE 

i  The  sympathetic  nervous  system      .       .       .      Frontispiece 

2  The  neurasthenic  triangle 18 

3  How  the  body  betrays  the  mind 38 

4  The  fear  of  great  heights 96 

5  The  high  tension  of  modern  life 108 

6  The  results  of  "  high  speed  "  on  man  and  machine       .  116 

7  Diagrams  illustrating  the  relation  of  the  threshold  of 

consciousness  to  the  sensation  of  pain       .       .       .  176 

8  Results  of  disregarding  "  danger  signals  "...  196 

9  Animal  pets  are  good  for  the  blues 238 

10  Fraudulent  methods  of  healing 288 

11  Young  and  old  at  play 378 

12  He  is  a  descendant  of  those  men  who  could  throw 

straight,  hit  hard,  and  run  fast 380 

13  A  revival  of  ancient  tribal  struggles       ....  382 

14  The  modern  eliminating  bath 392 

15  Hydrotherapy  for  nervous  disorders         ....  394 

16  Typical  scenes  in  massage 396 

17  Favorite  prescriptions   for  "nerves"       ....  398 

18  The  curative  power  of  nature  study      ....  446 

19  Taking  the  outdoor  "  play  cure  " 460 

20  Practicing  the   "  work   cure " 47° 

21  Give  the  children  a  chance  to  play 482 


XI 


PART  I 
A  STUDY  OF  THE  NERVOUS  STATES 


WORRY  and  NERVOUSNESS 

PART  I 
A  STUDY  OF  THE  NERVOUS  STATES 


CHAPTER  I 
SEVEN  SORTS  OF  NERVOUSNESS 

IN  UNDERTAKING  a  classification  of  nervous  disorders  for 
purposes  of  discussion  in  this  work,  it  should  be  remem- 
bered that  we  are  here  dealing  with  only  the  so-called  func- 
tional nervous  disorders  or  neuroses,  no  attention  whatever 
being  paid  to  that  vast  group  of  nervous  diseases  which  are 
accompanied  by  some  manifest  organic  change  in  the  bodily 
structure,  neither  will  we  treat  of  the  more  serious  functional 
disturbances  or  psychoses  when  they  assume  the  grave  aspects  of 
insanity  or  near-insanity. 

We  are  exclusively  concerned  at  this  time  with  the  considera- 
tion of  those  functional  nervous  disorders  which  are  so  largely 
amenable  to  proper  treatment;  those  nervous  states  to  the  suc- 
cessful management  of  which  it  is  possible  for  the  patients 
themselves  to  so  largely  contribute.  While  this  classification 
of  ''nerves  "  may  differ  slightly  from  that  to  be  found  in  the 
works  of  the  "  neurologist,"  it  will  be  found,  we  think,  on  closer 
examination,  to  be  clinically  sound,  and  to  afford  a  clearer  basis 
for  discussion  and  comprehension  from  the  standpoint  of  the 
laymen. 

CLASSIFICATION    OF    THE    NEURASTHENIC    STATES 

It  should  be  borne  in  mind  that  the  names  applied  to  these 
various   groups   of   "  nervous   symptoms  "   do  not  indicate  that 

3 


4  V/ORRY  AXD  XERVOUSXESS 

these  "  symptom  complexes  "  are  to  be  regarded  as  "  disease 
entities;"  for  functional  nervous  disorders  are  not  "diseases" 
in  the  sense  commonly  understood  by  the  laity.  These  nervous 
disturbances  are  not  a  morbid  or  pathological  entity  —  they  are 
simply  a  "clinical  picture"  —  a  group  of  sensations  and  feel- 
ings of  a  more  or  less  disordered  character,  to  which  we  find  it 
convenient  to  attach  certain  names,  in  order  to  facilitate  our 
discussions  of  their  origin,  character,  and  proper  remedial  treat- 
ment. 

From  the  viewpoint  of  the  laymen,  it  seems  to  me  that  we  must 
divide  these  functional  neuroses  into  the  following  seven  groups 
or  classes : 

1.  Chronic  Fear,  or  Common  Worry. 

2.  Xeurasthenoidia,  or  Xear-Xeurasthenia. 
the               3.  Neurasthenia,  or  Nervous  Exhaustion. 

eurasthenic  -  4-  Psychasthenia,  or  True  Brain  Fag. 
states  5.  Hysteria  —  The  Master  Imitator. 

6.  Hypochondria,  or  The  Chronic  Blues. 

7.  Simple  Melancholia. 

Subsequent  discoveries  and  increased  knowledge  may  force 
us  to  modify  this  classification,  but  from  the  practical  basis  of 
planning  their  conquest,  it  represents  the  best  I  can  do  at  the 
present  writing ;  and  it  will  now  be  necessary  explicitly  to  de- 
fine the  exact  meaning  which  we  attach  to  each  term  employed 
in  this  classification,  in  order  that  the  reader  may  fully  under- 
stand the  scope  and  significance  of  each  word  as  it  will  be  used 
throughout  this  work. 

DEFINITION    OF    NEURASTHENIC    TERMS 

It  should  further  be  borne  in  mind  by  the  reader  that  these 
seven  groups  of  nervous  disorders  in  which  we  purpose  to  in- 
clude all  cases  of  strictly  functional  nervous  disturbances,  may 
each  be  divided  into  still  other  sub-divisions,  which  will  be 
subsequently  considered :  such  as  the  various  fright  neuroses, 
the  sexual  neuroses,  insomnia,  habitual  headache,  nervous  dys- 
pepsia, imperative  acts  and  thoughts  (motor  and  mental  obses- 
sions V  as  well  as  the  commonly  observed  muscular  spasms 
such  as  twitching,  epileptoid  and  choreoid  jerkings,  etc. 


SEVEN  SORTS  OF  NERVOUSNESS  5 

1.  Chronic  fear —  worry.  A  purely  psychic  condition  charac- 
terized by  inability  to  relax  the  attention  when  it  has  once  fas- 
tened itself  on  a  given  idea  —  usually  a  persistently  entertained 
fear  of  some  sort.  The  condition,  when  it  becomes  chronic, 
is  characterized  by  diffidence,  disordered  nutrition,  more  or  less 
rise  in  blood  pressure,  and  must  be  regarded,  outside  of  certain 
hereditary  predisposition,  as  constituting  the  first  step  toward 
neurasthenia.    It  is,  in  reality,  the  earliest  pre-neurasthenic  state. 

2.  Ncurastlienoidia  —  near  neurasthenia.  This  is  the  petite 
neurasthenic  of  the  French,  or  common  everyday  ennui.  It  is 
the  condition  which  I  have  heretofore  diagnosed  as  near-neuras- 
thenia. I  have  chosen  this  term  to  embrace  that  large  class  of 
nervous  sufferers  whose  mental  and  physical  conditions  have 
progressed  down  the  neurasthenic  scale  far  enough  to  have 
passed  out  of  the  simple  class  of  chronic  worriers,  but  who  have 
not  yet  developed  the  classic  ear-marks  of  a  fairly  typical 
neurasthenia.  In  the  differential  diagnosis  of  neurasthenoidia 
and  neurasthenia  —  in  the  last  analysis  —  I  depend  to  some  de- 
gree upon  the  blood-pressure  findings. 

In  chronic  fear  —  all  things  equal  —  I  expect  to  find  more 
or.  less  elevation  of  the  blood-pressure.  In  typical  neurasthenia, 
there  is  almost  invariably  a  lowering  of  the  blood  pressure,  while 
neurasthenoidia  represents  that  great  transition  class  between 
the  high  pressure  of  chronic  worry  and  the  low  pressure  of  well 
developed  neurasthenia  —  a  class  in  which  the  blood-pressure  is 
practically  normal.  Therefore,  in  a  given  case,  if  it  appears 
to  be  a  mild  acquired  neurasthenia  presenting  many  of  the  physi- 
cal symptoms  of  nervous  exhaustion,  and  at  the  same  time  ex- 
hibiting a  normal  blood-pressure  —  or  a  pressure  slightly  ele- 
vated, (providing,  of  course,  there  exists  no  other  explanation 
of  the  blood-pressure  behavior)  then  I  prefer  in  such  a  case 
to  make  a  diagnosis  of  "  neurasthenoidia.'' 

3.  Neurasthenia  —  nervous  exhaustion.  Neurasthenia  may 
vary  in  degree  from  a  slight  "  neurataxia  "  which  permits  the 
patient  to  go  about  his  business,  to  a  profound  nervous  pros- 
tration which  renders  him  bed-fast.  This  condition  is  character- 
ized by  combined  mental  depression  and  physical  fatigue,  all  of 
which  is  apparently  due  to  "  nerve  exhaustion." 


6  WORRY  AND  NERVOUSNESS 

Neurasthenia  is  in  reality  nothing  more  than  a  medical  name 
for  a  large  group  of  symptoms  which  are  found  presenting 
themselves  as  a  result  of  some  functional  disorder  of  the  nerv- 
ous system,  or  as  a  result  of  some  other  form  of  vital  depres- 
sion. It  is  a  condition  founded,  as  a  rule,  on  heredity,  and  is 
usually  preceded  by  some  severe  mental  or  physical  strain  —  or 
both.  Neurasthenia  is  accompanied  by  characteristic  pains, 
insomnia,  loss  of  memory,  loss  of  appetite,  depression  of  blood- 
pressure,  etc. 

Neurasthenia  may  be  sub-classified  as  follows: 

a.  Cerebral  Neurasthenia. 

b.  Spinal  Neurasthenia. 

c.  Gastric  Neurasthenia. 

d.  Sexual  Neurasthenia. 

e.  Traumatic  Neurasthenia. 

4.  Psychasthenic!  —  true  brain  fag.  Under  this  term  I  group 
what  might  be  called  the  "  hereditary  form  of  the  neurasthenic 
states,"  in  contradistinction  to  the  common  or  acquired  forms. 
In  psychasthenia  the  symptoms  which  the  patient  complains  of 
are  very  largely  —  if  not  exclusively  —  purely  psychic  in  nature. 
The  blood-pressure  may  be  more  or  less  depressed  (not  so  un- 
varyingly as  in  acquired  neurasthenia)  and  the  minor  physical 
symptoms  of  nervous  exhaustion  may  be  present  in  varying 
degrees;  nevertheless,  the  characteristic  "symptom  complex" 
in  these  cases  is  largely  referable  to  the  mind.  It  is  essentially 
a  picture  of  psychic  exhaustion  in  contrast  with  the  nerve  or 
physical  exhaustion  of  neurasthenia.  In  practically  every  case 
of  well  marked  psychasthenia  there  will  almost  invariably  be 
found  abundant  evidence  of  a  neurotic  ancestry. 

5.  Hysteria  —  the  master  imitator.  Under  this  term  we  in- 
clude a  vast  group  of  highly  suggestible  patients  who  are  more 
or  less  hereditarily  tainted  with  psychasthenia  and  environmen- 
tally affected  with  neurasthenia.  Any  idea,  sensation,  or  emo- 
tion may  gain  such  an  over-powering  mastery  of  the  mind  and 
nervous  mechanism  (especially  the  sympathetic  nervous  system) 
as  completely  to  demoralize  the  patient's  nerve  control,  resulting 
in  the  adept  imitation  of  a  vast  group  of  mental  and  physical 
disorders. 


SEVEN  SORTS  OF  NERVOUSNESS  7 

In  general,  hysteria  is  further  characterized  by  hyperesthesias, 
pain  and  tenderness  (especially  over  the  ovaries,  head,  spine, 
etc.),  choking  sensations,  disturbance  of  sight  and  hearing, 
spasms,  convulsions,  paralyses,  retention  of  urine,  fever,  hallu- 
cinations, and  even  catalepsy.  In  hysteria  the  blood-pressure 
findings  are  variable  and  uncertain,  owing  to  the  nature  and 
severity  of  the  attack,  running  fairly  normal  between  attacks, 
although  usually  slightly  depressed  when  not  accompanied  by 
chronic  worry. 

6.  Hypochondria  —  the  chronic  blues.  Here  we  have  a  con- 
stant morbid  anxiety  about  personal  health  and  welfare,  often 
associated  with  some  simulated  diseases,  and  usually  accom- 
panied by  more  or  less  melancholia.  These  patients  have  become 
the  personification  of  their  long  entertained  fears,  wrhile  chronic 
worry  has  become  second  nature  to  them.  If  no  other  physical 
conditions  are  present  to  interfere,  the  blood-pressure  is  almost 
always  considerably  elevated  in  all  these  cases  of  hypochon- 
driasis. 

y.  Simple  melancholia.  This  constitutes  the  "borderland" 
group  of  cases  which  separate  the  relatively  harmless  and  cur- 
able classes  of  functional  nervous  diseases  (neuroses)  from  that 
serious  and  even  dangerous  group  of  organic  or  functionally  in- 
curable *  nervous  diseases  (psychoses),  which  begins  here  and 
extends  on  up  through  the  varied  forms  of  insanity. 

In  practically  all  cases  of  melancholia  there  will  be  found 
elevation  of  blood-pressure  accompanied  by  constant  depres- 
sion of  spirits  and  the  ever  present  gloomy  forebodings  of  the 
future.  (It  is  not  our  intention  in  this  work  to  treat  of  the 
melancholia  of  the  insane  variety;  that  belongs  to  the  alienist. 
We  desire  only  to  treat  of  the  slighter  forms  —  the  pre-insane 
varieties.) 

Each  of  these  seven  sorts  of  nervousness  will  be  amply  and 
fully  treated  in  later  chapters.  They  have  here  simply  been 
classified  and  defined  in  order  that  the  reader  may  acquire  the 


*  That  is,  incurable  as  compared  to  the  neuroses  —  and  from  the 
standpoint  of  self-treatment.  Not  always  incurable  from  the  view- 
point of  the  expert  alienist. 


8  WORRY  AND  NERVOUSNESS 

author's  meaning  and  viewpoint,  and  thus,  early  in  the  study  of 
this  book,  we  hope  to  prevent  those  serious  misunderstandings 
as  to  the  exact  meaning  of  words  —  misunderstandings  which 
result  in  "  nervous  readers  "  sometimes  being  led  into  harmful 
notions  that  they  are  suffering  from  some  ailment  far  more 
serious  than  the  facts  warrant.  I  have  learned  from  sad  ex- 
perience that  we  must  be  very  careful  and  explicit  in  all  our 
efforts  to  emancipate  these  "  nervous  sufferers  "  —  lest  we  un- 
intentionally plunge  them  into  a  worse  bondage  of  fear  and 
apprehension. 

It  will  be  noticed  that  the  author  is  sometimes  disposed  to 
classify  certain  of  his  "  nerve  "  cases  —  when  otherwise  in  doubt 
as  to  their  exact  nature  —  by  the  results  of  continued  blood-pres- 
sure observations.  I  have  found  the  blood-pressure  findings  of 
great  value,  not  only  in  the  diagnosis,  but  also  in  the  prognosis  — 
not  to  mention  its  great  service  as  an  encouragement  to  the  pa- 
tient in  his  fight  for  self-mastery  and  health.  And  so,  from  the 
standpoint  of  the  blood-pressure,  the  various  neurasthenic  states 
may  be  grouped  as  follows : 

1.  Chronic    Fear  —  Worry  —  As    a    general    rule  —  Blood-pressure 

raised. 

2.  Neurasthenoidia  —  As    a    general    rule  —  blood-pressure    normal. 

3.  Neurasthenia  —  As  a  general  rule  —  blood-pressure  lowered. 

4.  Psychasthenia  —  As    a    general    rule —  blood-pressure    lowered. 

5.  Hysteria  — As  a  general  rule  —  blood-pressure  variable. 

6.  Hypochondria  —  As    a    general    rule  —  blood-pressure    raised. 

7.  Melancholia  —  As  a  general  rule  —  blood-pressure  raised. 

DEFINITIONS    OF    NEUROLOGICAL   TERMS 

1.  Alienist:  An  expert  or  specialist  in  the  treatment  and  man- 
agement of  insanity. 

2.  Hypochondriasis:   Hypochondria. 

3.  Lesion:  A  physical  hurt,  a  wound,  a  local  degeneration  of 
bodily  structures.  If  a  lesion  is  present,  actual  bodily  changes 
can  be  discerned,  at  least  with  the  aid  of  the  microscope. 

4.  Neurosis:  A  functional  (and  presumably  curable)  disease 
or  disorder  of  the  nervous  system.  In  the  neuroses  there  are 
no  known  or  discoverable  lesions  to  be  found  in  the  body. 

5.  Neurotic:  Pertaining  to  nervousness;  hereditary  taint  pre- 
disposing to  the  neurasthenic  states,  a  manifest  tendency  toward 
some  of  the  so-called  neurasthenic  states. 


SEVEN  SORTS  OF  NERVOUSNESS  g 

6.  Psychosis:  A  real  disease  of  the  mind;  a  true  insanity  or 
disorder  approaching  thereto.  Psychoses  require  additional  and 
different  treatment  than  that  outlined  in  this  work. 

7.  Psychotherapy:  The  treatment  or  cure  of  any  disease  by 
direct  or  indirect  influence  upon  the  mind.  Mental  therapeu- 
tics—  scientific  mind  cure  —  embraces  such  methods  as  sugges- 
tion, educational  therapeutics,  persuasion,  will-training,  faith 
cure,  psvchanalysis,  emotional  elimination,  recreation,  relaxa- 
tion, study,  work,  rest,  social  service,  prayer,  religion,  also  hyp- 
notism, etc.,  etc. 

8.  Psychokinesia:  An  explosive  cerebral  action,  due  to  de- 
fective inhibition. 

9.  Psychoncurosis:  A  nervous  disorder  affecting  the  mind  and 
body  which  is  regarded  as  being  largely,  if  not  wholly,  of  mental 
origin. 

10.  Psychosensory :  Pertaining  to  the  conscious  perception  of 
sensory  impulses  to  the  mind  and  to  sensation. 

11.  PsycJianalysis:  The  method  of  Freud  (Jung)  of  eliciting 
from  nervous  patients,  against  or  without  the  active  or  con- 
scious co-operation  of  their  wills,  ideas  and  facts  regarding  their 
past  emotional  experiences,  their  dreams,  etc. 

12.  Psychataxia:  A  disordered  mental  state  characterized  by 
inability  to  fix  or  concentrate  the  attention. 

13.  Psychiatry:  The  treatment  of  bona  fide  mental  diseases. 
The  scientific  treatment  and  management  of  the  insane. 

14.  Psychic:   Pertaining  to  the  mind. 

15.  Psychalgia:  Pain  attending  or  resulting  from  a  purely 
mental  operation.    Mind  pain  or  soul  pain. 

SUMMARY  OF  THE  CLASSIFICATION   OF  THE   NERVOUS   STATES 

the  psycho-neuroses  2.  Neurasthenoidia —  near     neu- 

1.  Chronic  fear  — worry.  rasthenia. 

a.  Prolonged  grief  and  sor-  a.  Hereditary. 

row.  b.  Acquired. 

b.  Premonitions     and     dis-  c.  Accidental, 
appointments.                       Neurasthenia— nervous      ex- 


c.  Crystallized    fears. 

d.  Definite  dreads. 

e.  Obsessions  —  mental  and 

motor. 

f.  Nervous  high  tension.  c-  Gastric- 

g.  Unsatisfied         happiness  d.  Sexual. 

hunger.  e.  Traumatic. 


haustion. 

a.  Cerebral. 

b.  Spinal. 


10 


WORRY  AXD  NERVOUSNESS 


4.  Psychasthenic!  —  true  brain  fag. 

a.  Mental  incapacity. 

b.  Disorders  of  memory. 

c.  Brain  storms. 

5.  Hysteria  —  the    master    imita- 

tor. 

a.  Exaggerated  psychic  con- 

tagion. 

b.  Demoralized  sympathetic 

control. 

c.  Combined       brain       and 

nerve  storm. 

6.  Hypochondria  —  the      chronic 

blues. 

a.  Periodical  depression. 

b.  Chronic       auto-intoxica- 

tion. 

c.  Combined    physical    and 

psychic  states. 

7.  Melancholia. 

a.  Simple  melancholia. 

b.  True  melancholia. 

c.  Circular  insanity. 


EORDERLAXD    XERVOUS    DISORDERS 

1.  Chorea  —  St.  Vitus'  dance. 

2.  The  Tics  —  twitchings. 

3.  Stuttering  and  stammering. 

4.  Ataxias  —  walking,     writing, 

etc. 

5.  Tremors   and  tremblings. 

6.  Dreams  and  hallucinations. 

7.  Alcoholism   and    dipsomania. 

8.  Drug  habits. 

9.  Persistant  insomnia. 

10.  Migraine    —    nervous       sick 

headache, 
ir.  Epilepsy  and  pseudo-epilepsy. 
12.  Defectives  and  degenerates. 

a.  Idiocy. 

b.  Feeble-mindedness. 

c.  Pauperism. 

d.  Prostitution. 

e.  Criminality. 


CHAPTER  II 

HEREDITY  AND  ENVIRONMENT  AS  NEURASTHENIC 

FACTORS 

WHEN  a  careful  search  is  made  into  the  family  histories 
of  the  sufferers  from  various  nervous  disorders  there 
will  be  discovered  in  all  cases  of  psychasthenia  and  in  a  vast 
majority  of  neurasthenia,  an  unmistakable  neurotic  ancestry, 
exhibiting  an  hereditary  taint  embracing  neurasthenia,  psychas- 
thenia, hysteria,  migraine,  hypochondria,  melancholia,  chorea, 
alcoholism,  epilepsy,  etc. 

ANCESTRAL  NEUROTIC  TAINT 

It  does  not  follow  that  the  child  is  doomed  to  suffer  in  life- 
long bondage  to  neurasthenia  or  psychasthenia  because  of  the 
fact  that  he  springs  from  a  neurotic  ancestry,  because  not  all 
of  the  offspring  of  a  neurotic  stock  are  thus  afflicted.  But  it 
does  follow  that  in  practically  all  cases  of  psychasthenia  we 
are  able  to  detect  the  neurotic  strain  if  we  go  back  far  enough 
into  the  family  history  and  with  sufficient  care ;  and  that  in  the 
vast  majority  of  cases  of  well  marked  neurasthenia,  we  are  also 
able  to  elicit  a  "  nervous  "  family  history. 

Of  these  neurologically  disinherited  souls,  Dubois  has  well 
written : 

From  effects  of  heredity  and  atavism,  often  from  the  fault  of  the 
parents  or  from  unfavorable  hygienic  conditions,  many  children  find 
disease  in  their  cradles  and  will  never  enjoy  that  precious  blessing 
of  physical  health.  More  ill-favored  still  are  those  to  whom  nature 
has  given  a  gloomy  disposition,  those  "  sorrowful  souls,"  as  W. 
James  calls  them,  who  can  only  react  the  wrong  way,  in  the  sense 
of   sadness. 

These  martyrs  to  heredity  and  perverted  education  are  innumer- 
able.   The  world  does  not  understand  them ;  it  ill-treats  them.  There 

II 


12  WORRY  AND  NERVOUSNESS 

is  no  hospital  with  neat  white  beds,  no  gracious  nurses'  faces,  no  doc- 
tor, kind  though  gruff,  for  these  unfortunates  who  are  suffering  in 
mind  and  who  need  both  to  be  consoled  and  stimulated.  We  do  not 
know  where  to  put  them;  the  lunatic  asylum,  which  seems  really 
indicated,  would  be  a  prison  to  them;  their  homes,  which  ought  to  be 
their  refuge,  are  the  very  places  where  the  evil  was  created,  not 
only  through  the  unavoidable  influence  of  psychopathic  heredity, 
but  also  by  education,  by  mental  contagion.  Most  frequently  the 
parents  do  not  recognize  the  mental  likeness,  and  though  quite  as 
abnormal  in  mind  as  their  offspring,  blame  them  for  their  misfor- 
tune. 

NEURASTHENIC    ENVIRONMENT 

We  cannot  deny  that  the  fact  that  a  large  number  of  cases 
of  neurasthenia  are  appearing  nowadays  in  persons  whose  fam- 
ilies—  on  both  sides  of  the  house  —  have  heretofore  been  en- 
tirely or  quite  free  from  neurotic  taint.  Nervous  breakdowns 
are  appearing  in  increasing  numbers  in  families  whose  histories 
seem  to  be  neurologically  sound.  I  am  forced  to  recognize 
that  many  of  these  newly  appearing  neurasthenias  are  not  based 
upon  any  discoverable  hereditary  taint.  They  are  due  largely 
to  a  vicious  environment.  They  represent  premature  break- 
downs on  the  part  of  a  nervous  mechanism  which  has  persistently 
been  forced  to  exert  itself  far  beyond  the  measure  of  human 
endurance. 

Many  of  our  modern  breakdowns  also  represent  the  coming 
to  the  surface  of  a  strain  of  nervous  weakness  which  has  in  the 
past  been  increasing  from  generation  to  generation,  but  which 
has  not  heretofore  been  sufficiently  marked  or  well  developed 
to  assume  neurasthenic  proportions ;  but  which,  under  the  mod- 
ern high  tension  of  the  incessant  battle  for  riches  and  fame, 
readily  assumes  the  gravity  of  neurasthenia  or  near-neuras- 
thenia; thus  laying  the  ancestral  foundations  for  a  new  and 
future  line  of  neurasthens  and  psychasthens. 

Many  of  our  present  day  new  and  non-hereditary  neuras- 
thenics owe  their  origin  to  that  increasing  craving  for  self- 
gratification  and  unwholesome  pleasures  —  that  sort  of  pleasure- 
madness  which  has  so  largely  permeated  all  classes  of  society 
from  the  highest  to  the  lowest,  and  which  ever  seeks  to  dis- 


HEREDITY  AND  ENVIRONMENT  13 

cover   still   more   exciting,   thrilling,   and   pernicious    forms   of 
stimulation  and  entertainment. 

COMPLEXITY  OF   MODERN   CIVILIZATION 

And  so,  while  heredity,  pernicious  personal  practices,  and 
an  unhygienic  environment,  may  all  be  concerned  in  the  greatly 
increased  production  of  neurasthenics ;  notwithstanding  all  these 
established  and  accepted  factors,  there  is  in  the  mind  of  the 
author  still  another  powerful  factor  which  is  exceedingly  in- 
fluential just  now  as  an  influence  in  the  increased  production 
of  neurasthenia.  I  refer  to  the  fact  that  the  complexities  and 
complications  of  modern  industrial  business  and  social  life  are 
increasing  and  multiplying  with  such  rapidity,  that  the  average 
human  brain  and  nervous  system  is  unable  to  adapt  and  adjust 
itself  with  sufficient  alacrity  to  keep  pace  with  the  rapid  prog- 
ress and  gigantic  evolutions  now  taking  place  in  the  world  about 
us.  Neurasthenia  is  a  part  of  the  price  which  the  human  race 
is  paying  for  the  rapid  advancement  and  the  wonderful  achieve- 
ments attendant  upon  the  business,  the  art,  and  the  science  of 
the  twentieth  century. 

At  least  this  new  stress  and  strain  of  modern  life,  becomes 
a  factor  accounting  for  the  great  increase  of  nervous  disorders 
among  those  classes  of  society  who  are  forced  to  labor  for  a 
livelihood.  And  it  is  a  well  recognized  fact  that  the  number 
of  weaklings,  neurotics,  and  defectives  is  increasing  in  alarming 
proportions.  The  possession  of  will-power  is  deplorably  on  the 
decrease,  while  the  lower  or  baser  passions  seem  to  be  gaining 
more  and  more  control  over  certain  classes  of  society  with  each 
succeeding  generation. 

DIFFICULTIES  IN  DIFFERENTIATION 

And  so  it  appears  that,  after  having  made  every  and  due  al- 
lowance for  all  environmental  influences  which  might  tend  to 
increase  the  nervous  states  in  this  day  and  generation,  the 
fundamental  fact  persists  that  heredity  is  after  all  the  chief 
factor  in  the  production  of  that  nervous  state  which  leads  up  to 
neurasthenia  and  its  neurotic  cousins.  We  all  enter  this  world 
equipped  with  a  nervous  system  which  is  endowed  with  a  cer- 


i4  WORRY  AND  NERVOUSNESS 

tain  degree  of  nervous  strength.  (Fig.  I.)  This  inheritance  con- 
stitutes our  neurological  capital  and  during  our  lifetime  we  are 
compelled  to  live  thereon;  our  interest  yield  therefrom 
being  wholly  determined  by  the  wisdom  or  lack  of  wisdom  with 
which  we  react  to  our  surroundings  from  day  to  day.  Careless 
living  may  effectually  dissipate  a  vast  inheritance  of  vital  force 
and  nervous  energy;  while  on  the  other  hand,  careful  living  and 
a  judicious  administration  of  even  a  scanty  inheritance  of  nerv- 
ous vitality  may  enable  one  to  reap  a  rich  reward  of  good  health 
in  this  life  and  at  the  same  time  add  something  to  the  prospects 
of  stronger  nerves  in  the  children  of  future  generations. 

Forel,  speaking  of  the  difficulties  of  recognizing  the  differ- 
ences between  heredity  and  acquired  nervous  disturbances,  says: 

It  is  practically  impossible  in  every  case  of  this  sort  to  separate 
what  is  purely  hereditary  from  what  is  acquired  in  the  course  of 
development ;  both  groups  of  factors  usually  work  together  to  engen- 
der a  product  as  unfortunate  for  the  individual  himself  as  for  soci- 
ety. What  is  abnormal  here  is  the  original  disposition.  Through 
training  and  the  relations  of  life  this  bad  disposition  can  be  strength- 
ened, i.  e.,  made  worse,  or,  if  it  is  not  too  powerful  and  one-sided, 
it  can  be  more  or  less  successfully  combated  and  dammed  back. 

Desequitibres  (unbalanced)  is  a  term  used  by  the  French  to  indi- 
cate those  pathological  natures  who  lack  balance  in  this  or  that  or  in 
many  respects,  and  whose  thought  and  feeling  and  will  are  generally 
unsteady  and  without  proper  measure.  The  modern  term  psychas- 
thenia,  or  mental  irritable  weakness,  can  also  be  used  in  the  descrip- 
tion of  such  cases. 

Where  does  the  inherited  tendency  come  from?  Why  do  people 
come  into  the  world  with  a  strong  tendency  to  mental  and  nervous 
diseases?  The  answer,  "Because  their  parents  or  ancestors  were 
mentally  diseased,"  is  not  satisfactory,  for  where  did  these  get  their 
disease  or  tendency  to  it?  The  sickly  tendency  must  be  introduced 
somewhere,  and  so  the  question  comes  back  to  the  following :  What 
causes  produce  or  maintain  in  a  given  race  or  a  given  generation  the 
tendency  to  engender  mental  and  nervous  disturbances  in  their 
descendants?  Since  only  that  can  be  inherited  which  affects  or 
injures  the  germ  plasm  itself,  purely  acquired  local  diseases  of  the 
nervous  system  as  such  can  produce  no  pathological  tendency  in  the 
germ.  Moreover,  since  under  normal  conditions  of  life,  inherited 
pathological  tendencies  gradually  tend  to  disappear  in  the  course  of 


HEREDITY  AXD  EXVIROXMEXT  15 

a  few  generations  through  what  is  called  regeneration,  a  progressive 
degeneration  must  have  causes  which  are  progressive  or  at  least  con- 
tinually renewed,  and  cannot  rest  altogether  on  old  inherited  tend- 
encies. 

THE    GERM    PLASM 

The  ova  and  spermatozoa  represent  parts  of  the  human 
machine  which  are  quite  unable  to  look  after  their  own  hygiene. 
We  say  jokingly  that  one  cannot  be  too  careful  in  the  choice 
of  a  parent;  but,  the  truth  is,  we  cannot  choose.  And  so, 
because  of  the  fact  that  our  posterity  cannot  have  the  slightest 
voice  in  selecting  their  nervous  systems,  it  becomes  a  sacred 
duty  for  parents  to  look  out  for  the  health  of  their  offspring. 
It  is  all  very  well  to  say  that  we  must  not  assume  the  role  of 
fate,  that  we  must  leave  the  selection  of  the  human  race  to 
chance  and  nature.  While  it  is  a  fact  that  the  animal  kingdom 
does  thus  apparently  blindly  risk  its  destiny,  it  should  be  re- 
membered that  animals  do  not  practice  medicine ;  they  do  not 
take  care  of  the  sick  and  disabled,  they  do  not  protect  the  weak 
and  prolong  the  life  of  the  unfit,  so  that  with  them  death  pro- 
vides for  the  selection.  But  with  man  it  is  different;  we  take 
care  of  the  sick  and  afflicted,  we  kill  off  the  sound  and  healthy 
by  war,  and  as  one  authority  has  well  said : 

We  make  natural  alliances  more  difficult  by  cultivating  prostitu- 
tion and  venereal  diseases,  by  constant  military  service,  and  by  de- 
stroying normal  sexual  selection  in  marriages  for  the  sake  of  wealth 
and  position ;  we  cultivate  drink  and  other  bad  habits,  and,  in  short, 
constantly  play  the  part  of  a  malign  fate  that  provides  for  the  de- 
terioration of  the  race.  To  be  sure  there  is  a  certain  justification 
for  bringing  against  our  requirements  the  non-success  of  the  Spar- 
tan lawgiver,  Lycurgus.  But,  as  might  be  expected  from  his  times 
and  ignorance  of  science,  he  carried  out  a  selection  for  bodily 
strength  only,  and  totally  neglected  mental  vigor;  and  moreover 
he  committed  the  great  blunder  of  allowing  the  slavery  of  the  Helots 
to  continue.  Thus  he  helped  to  breed  a  people  who  were  physically 
strong,  to  be  sure,  but  stupid  and  lazy.  He  had  forgotten  the  main 
thing,  the  cultivation  of  work;  and  history  teaches  that  at  last  the 
slaves  by  their  work  got  ahead  of  their  masters,  so  that  slavery 
destroyed  the  latter  and  not  the  former.    It  is  also  argued  that  arti- 


16  WORRY  AXD  XERVOUSXESS 

ficially  bred  varieties  of  animals  and  plants  are  unable  to  preserve 
themselves  in  nature.  But  here  it  is  forgotten  that  these  races  are 
not  selected  for  their  own  strength  and  ability  to  fight  their  way  in 
life,  but  only  for  the  sake  of  certain  qualities  which  we  desire  for 
our  own  purpose,  and  that  in  making  such  a  selection  we  directly 
destroyed  their  fitness  for  the  struggle  for  existence. 

OBSCURE  NERVOUS  TAIXT 

We  must  not  forget  the  fact  that  we  are  not  born  artist-. 
musicians,  or  scientists;  we  do  not  come  into  the  world  predes- 
tinated to  be  great  men  or  small  men,  good  men  or  bad  men ;  we 
are  merely  thrust  into  this  world  possessing  a  brain  and  nervous 
system  more  or  less  well  organized,*  and  in  general  our  charac- 
ter is  destined  to  become  largely  what  we  make  it  by  virtue  of  the 
manner  in  which  we  allow  or  compel  ourselves  to  react  to  our 
environment.  And  so  while  it  is  will-power  that  so  largely 
determines  the  manner  in  which  we  will  respond  to  the  various 
stimuli  of  our  surroundings,  nevertheless,  the  strength  or  weak- 
ness of  the  inherited  nervous  system,  experience  proves,  goes  a 
long  way  toward  determining  the  outcome  and  final  destiny  of 
the  individual's  struggle  with  his  own  environment. 

In  the  case  of  many  a  nervous  breakdown  following  some  pro- 
longed mental  stress  or  severe  physical  strain,  we  are  entirely 
too  prone  to  take  the  patient's  word  for  it  that  there  is  no  neu- 
rotic taint  in  the  family  history.  And  so  we  are  quick  to  make 
a  diagnosis  of  accidental  or  acquired  neurasthenia  and  charge 
it  all  up  to  a  severe  attack  of  influenza,  overwork,  business  dif- 
ficulties, family  trouble,  etc. ;  whereas  a  painstaking  search 
back  into  the  patient's  heredity  would  have  in  almost  every  case 
disclosed  a  smoldering  neurotic  fire,  which  only  required  the 
occasion  of  environmental  stress  or  accidental  strain  to  fan  it 
into  an  immediate  and  full  fledged  neurasthenic  conflagration ; 


*It  should  be  borne  in  mind  that  the  brain  and  nervous  system 
of  the  new-born  child  are  practically  all  there  at  birth  —  that  is, 
while  the  individual  cells  of  all  the  other  tissues  of  the  body  multi- 
ply and  greatly  increase  in  number,  those  of  the  nervous  system  only 
develop  and  grow  —  there  occurs  little  or  no  increase  in  the  number 
of  cells. 


HEREDITY  AND  ENVIRONMENT  17 

and  so  the  possibilities  of  the  whole  nervous  smashup  were  all 
the  while  concealed  within  the  very  cells  and  fibers  of  the 
brain  and  nervous  system  which  constituted  his  hereditary  legacy 
handed  down  through  the  ancestors  of  preceding  generations. 
It  not  infrequently  develops  that  a  case  of  "  nerves  "  which  so 
perplexes  us  in  a  certain  individual  is  quite  easily  understood 
when  we  have  an  opportunity  to  peep  into  the  home  of  this 
patient's  family  and  thus  observe  in  brother  or  sister  the  di- 
verse outcropping  of  this  same  neurotic  taint. 

PSYCHOPATHIC  FAMILIES 

It  is  the  author's  experience,  that  in  nine  cases  out  of  ten 
the  true  neurasthenic  belongs  to  a  psychopathic  family,  in 
which  there  is  an  unfailing  history  of  neurotic  manifestations 
as  one  goes  back  in  the  ancestral  archives,  there  discovering  an 
increasing  panorama  of  neurotic  disturbances  ranging  all  the  way 
from  common  nervous  sick-headache  up  to  epilepsy  and  insanity. 

When  the  inherited  nervous  tendencies  of  an  individual  are 
once  finally  determined  by  the  union  of  the  parental  germ  cells, 
there  then  comes  the  embryological  period  during  the  preg- 
nancy of  the  mother.  The  hygiene  of  pregnancy  is  really  a 
question  of  good,  healthy  nourishment.  Here  also  as  well  as 
during  the  time  the  child  is  nourished  through  the  mother's 
milk,  all  poisonings,  especially  alcoholic  poisoning,  are  extremely 
injurious.  Von  Bunge  has  even  shown  that  alcoholism  in 
the  ancestors  seriously  cripples  even  the  woman's  ability  to 
nurse  her  offspring.  It  is  a  reprehensible  and  ruinous  practice 
to  give  pregnant  women  and  nursing  mothers  alcohol  to  drink, 
for  it  injures  the  embryo  and  the  child  tremendously.  Diseases, 
emotional  excitements,  nutritional  disturbances,  and  everything 
also  that  injures  the  bodily  health  and  especially  the  nervous 
life  of  the  mother,  naturally  have  more  or  less  of  an  indirect 
effect  upon  the  life  of  the  embryo,  in  just  the  same  manner  and 
for  the  same  reason  that  the  nervous  and  physical  condition  of 
the  nursing  mother  will  directly  affect  the  health  and  behavior 
of  the  infant  that  feeds  at  her  breasts.  Such  instances  have 
nought  to  do  with  heredity  —  it  is  a  matter  of  chemistry  and 
contagion. 


18  WORRY  AND  NERVOUSNESS 

PRE-NATAL    INFLUENCE    AND    BIRTH    MARKS 

Incidentally,  in  this  connection,  it  should  be  stated  that  the 
hereditary  influences  which  work  to  shape  the  nervous  system 
of  the  child  are  all  in  operation  at  the  time  the  germ  cells  (sex 
cells)  are  originated  within  the  organisms  of  the  parents.  The 
determiners  for  the  child's  nervous  system  are  all  formed  and 
completed  in  the  germ  cells  at  the  time  conception  takes  place. 
The  child's  brain  and  nervous  system  is  only  developed  by 
growth  during  the  nine  months  of  pregnancy.  The  fact  that 
the  mother  may  read  her  Bible  incessantly  during  the  period 
of  pregnancy  will  not  contribute  to  producing  either  a  studious 
or  pious  offspring.  Such  tendencies  were  determined  long  be- 
fore in  accordance  with  a  law  of  hereditary  determiners,  present 
in  the  male  and  female  germ  cells  at  the  time  the  new  life  was 
inaugurated. 

It  should  be  further  stated  in  this  connection  that  the  sup- 
posed productions  of  malformations,  birthmarks,  etc.,  as  a  re- 
sult of  alarming  experiences  on  the  part  of  a  pregnant  woman 
have  long  since  been  proven  to  be  wholly  fallacious.  It  is  en- 
tirely within  the  bounds  of  scientific  conservatism  to  state  that 
the  entire  doctrine  of  "  birthmarks  "  has  been  proven  fictitious, 
and  that  the  mental  frights  and  other  emotional  experiences  of 
the  pregnant  woman  can  have  no  more  direct  influence  in  the 
production  of  "birthmarks,"  or  in  injuring  the  nervous  sys- 
tem of  the  foetus,  than  could  the  fact  of  a  setting  hen  becom- 
ing suddenly  frightened,  in  any  way  result  in  changing  the 
course  of  predetermined  development  taking  place  in  any  one 
of  the  eggs  on  which  she  might  be  setting. 

HEREDITY,    ENVIRONMENT,    AND    EDUCATION 

We  are  compelled  to  accept  the  fact  that  heredity  is  the  base 
of  the  neurasthenic  triangle.  The  two  sides  are  represented 
by  environment  and  education.  (Fig.  2.)  And  we  must  fur- 
ther recognize  the  possibility  of  largely  overcoming  the  results 
of  even  the  combined  influence  of  both  heredity  and  environ- 
ment by  the  persistent  training  of  the  mind  and  nervous  sys- 
tem to  obey  the  mandates  of  an  enlightened  and  energized 
will.      Self-training  and  self-mastery,  as  will  be   shown   later, 


CHARACTER 


The  Neurasthenic  Triangle 


HEREDITY  AND  ENVIRONMENT  ro, 

are  able  to  exert  a  marvelous  power,  enabling  us  even  to  escape 
the  direful  consequences  of  what  would  otherwise  prove  to  have 
been  a  pernicious  heredity  and  a  fatal  environment. 

Parents  not  only  owe  their  children  a  biologic  duty  to  endow 
them  with  a  normal  nervous  mechanism  at  or  before  birth, 
but  also  do  they  owe  their  children  a  sociologic  debt  which  can 
only  be  paid  by  the  proper  conservation  and  training  of  that 
nervous  system;  and  this  includes  the  protection  of  the  child 
from  morbid  fears,  injurious  emotional  excitement,  and  other 
excesses  and  abuses  of  the  nervous  system,  including  the  sexual 
functions,  which  would  tend  to  break  down  or  weaken  the  nerv- 
ous vitality,  predispose  to  neurasthenia,  thus  jeopardizing  the 
child's  future  health  and  happiness. 

In  this  day  of  high  nervous  tension  and  constantly  increasing 
neurasthenia,  the  duty  devolves  upon  parents,  as  never  before, 
to  keep  close  to  their  children,  maintaining  a  perfect  under- 
standing between  parent  and  child,  thus  contributing  to  that 
natural  and  even  development  of  the  nervous  system  which  is 
so  essential  to  strong  vitality  and  vigorous  will-power  later  in 
life. 

HEREDITY   FEAR 

Many  unfortunate  nervous  sufferers  live  in  constant  fear  of 
numerous  supposedly  hereditary  diseases.  They  fear  they  are 
destined  to  die  of  cancer,  tuberculosis,  or  some  other  dreadful 
and  malignant  disease.  Such  imaginary  sufferers  should  come 
to  know  that  practically  no  known  disease  is  hereditary  —  as 
such;  that  while  certain  local  and  general  defects  present  in 
the  ancestral  strain  are  inherited,  acquired  characteristics  and 
definite  diseases  are  not  inherited.  This  has  been  aptly  put  by 
some  one  who  said,  "  wooden  heads  may  be  inherited,  but  wooden 
legs  are  not." 

The  average  neurasthenic  who  may  possibly  have  inherited 
some  tendency  in  a  general  way  towards  his  nervousness,  should 
thoroughly  understand  that  he  has  not  inherited  and  cannot 
inherit  any  one  of  the  many  serious  disorders  which  he  imagines 
afflict  him  and  which  he  further  imagines  descended  down  upon 
him  from  his  otherwise  honored  and  respected  ancestors. 


20  WORRY  AXD  XERVOUSNESS 


SUMMARY  OF  THE  CHAPTER 

1.  A  neurotic  history  will  be  found  in  the  ancestral  strains 
of  practically  all  psychasthenes  and  the  majority  of  neurasthenes; 
but  not  all  the  offspring  of  neurotic  parents  are  thus  affected. 

2.  Many  so-called  "  sorrowful  souls  "  inherit  their  melancholy 
disposition.     They  are  born  martyrs  to  heredity. 

3.  Vicious  environment,  persistent  overwork,  and  a  greedy 
ambition,  coupled  with  a  latent  hereditary  neurotic  tendency, 
are  responsible  for  many  nervous  breakdowns. 

4.  Pleasure-madness  —  self-gratification  —  lies  at  the  bottom 
of  many  a  case  of  "  nerves." 

5.  The  complexities  of  modern  business  and  the  complica- 
tions of  present-day  society  both  work  together  for  the  produc- 
tion of  nervous  exhaustion  in  certain  predisposed  individuals. 

6.  Neurasthenia  is  a  part  of  the  price  the  race  is  paying  for 
the  rapid  progress  and  development  of  our  twentieth  century 
civilization. 

7.  Weaklings,  neurotics,  and  defectives  are  apparently  on  the 
increase,  while  will-power  and  self-mastery  —  control  of  the 
emotions  and  the  passions  —  seem  to  be  decreasing. 

8.  Every  human  being  enters  this  world  with  an  inheritance 
of  strong  nerves  or  weak  nerves ;  and  their  method  of  reacting 
to  their  environment  constitutes  the  determining  factor  of 
nervous  vitality. 

9.  It  is  often  difficult  to  differentiate  between  hereditary  and 
acquired  nervousness.  Inherited  nervous  taint  tends  to  dis- 
appear, if  neurotic  factors  are  not  added  in  each  succeeding 
generation. 

10.  The  "germ  plasm"  (sex  cells)  contain  the  secrets  of 
heredity.  Their  conservation  is  the  sacred  duty  of  the  race. 
They  transmit  the  in-bred  traits  of  the  stock,  but  not  the  recently 
acquired  characteristics. 

11.  "Natural  selection"  may  obtain  in  the  animal  kingdom; 
but  modern  civilization  renders  necessary  the  "  selection  of 
science  "  in  order  to  strengthen  and  upbuild  the  race. 

12.  Will-power  largely  determines  the  manner  of  our  re- 
sponse to  nervous  stimuli ;  its  strength  or  weakness  being  regu- 
lated by  inherited  tendencies;  thus  is  determined  the  result  of 
the  individual's  battle  with  environment. 

13.  The  neurasthenic's  legacy  of  nerve  cells  and  fibres  contain 
the  potential  possibilities  of  the  neurotic  conflagration  which  was 
ignited  by  environmental  stress  or  accidental  strain. 

14.  Ninety  per  cent  of  neurasthenics  belong  to  psychopathic 
families,  whose  ancestral  archives  contain  a  rich  assortment  of 
neurotic  taints. 

15.  The  use  of  alcohol  by  the  mother  greatly  influences  the 


HEREDITY  AND  ENVIRONMENT  21 

nervous  system  of  both  the  unborn  child  and  the  nursing  infant. 

16.  At  the  time  of  conception  the  "  sex  cells  "  contain  those 
hereditary  determiners  which  so  powerfully  regulate  future 
behavior.     Growth  only  is  affected  by  the  period  of  pregnancy. 

17.  Conventional  teachings  regarding  pre-natal  influence  are 
largely  without  foundation.  The  doctrine  of  "  birth-marks  "  has 
been  proven  fictitious. 

18.  Heredity  is  the  base  of  the  neurasthenic  triangle.  Envi- 
ronment and  education  represent  the  other  two  sides. 

19.  Will  training  and  self-mastery  go  a  long  way  toward 
delivering  neurotic  sufferers  from  the  terrible  results  of  both 
heredity  and  environment. 

20.  Parents  owe  their  children  a  biologic  duty,  first  to  impart 
and  then  subsequently  to  train  their  nervous  systems  in  such  a 
manner  as  to  safeguard  them  from  neurotic  tendencies. 

21.  The  neurasthenic's  fear  of  inherited  diseases  is  a  delusion. 
As  the  term  is  used  by  science,  definite  diseases  are  not  directly 
hereditary. 


CHAPTER  III 

INFLUENCE  OF  THE  PHYSICAL  HEALTH  ON  THE 

MIND 

WHILE  we  recognize  that  the  mind  holds  the  balance  of 
power  and  control  over  many  of  the  complicated  physical 
processes  which  are  concerned  in  health  and  disease,  never- 
theless, we  are  forced  to  give  almost  equal  recognition  to  the 
powerful  and  dominating  —  sometimes  tyrannical  —  control  of 
the  mind  by  a  diseased  and  disordered  body. 

SUNSHINE    AND    CHEERFULNESS 

There  can  be  little  doubt  that  lack  of  sunlight  is  often  respon- 
sible for  a  lack  of  mental  cheerfulness.  There  is  more  than  an 
accidental  relationship  between  the  sunshine  of  the  body  and 
the  sunshine  of  the  soul.  Indoor  living  predisposes  to  mental 
despondency;  and  a  sedentary  life,  in  many  cases,  leads  directly 
to  moral  depression.  There  is  a  direct  relation  between  the 
physical  darkness  of  the  slum  tenement  and  the  spiritual  dark- 
ness and  moral  depravity  of  those  who  dwell  therein. 

Sunshine  is  the  fountain  of  physical  energy  and  the  well- 
spring  of  mental  cheer,  and  it  even  contributes  indirectly  to 
strengthening  the  moral  courage.  Sunshine  in  the  home  favors 
sunshine  in  the  soul.  Sunny  homes  help  to  make  sunny  people  — 
happy  and  healthy  people. 

Even  the  cloudy  day,  but  a  passing  incident  in  our  lives,  mark- 
edly influences  the  temper  and  disposition  of  many  persons.  It 
is  doubtful  if  the  best  of  people  are  as  generous  and  philan- 
thropic on  a  nasty,  rainy  day,  as  they  are  on  a  sunshiny  after- 
noon of  a  beautiful  summer's  day. 

FRESH    AIR    AND    THE    MENTAL    STATE 

The  mental  powers  of  the  children  of  the  slums  are  retarded 
by  lack  of  fresh  air  and  sunshine.     When  the  brain  is  stuffy 

22 


INFLUENCE  OF  THE  PHYSICAL  HEALTH        23 

the  mental  action  is  slow,  and  the  memory  sluggish;  the  mind 
cannot  be  ventilated  unless  the  lungs  be  ventilated;  and  the 
lungs  cannot  be  ventilated  unless  the  living  or  working  rooms 
also  be  ventilated.  The  proper  lighting  and  ventilation  of  the 
schoolroom  is  directly  concerned  in  the  mental  development 
and  the  intellectual  training  of  the  children  in  attendance. 
Many  persons  suffer  all  day  from  mental  dullness,  and  gain 
the  reputation  of  possessing  a  mean  disposition,  as  the  result 
of  breathing  all  night  the  foul  and  polluted  atmosphere  of  an 
unventilated  sleeping  room. 

The  breathing  of  impure  air  directly  and  powerfully  influ- 
ences the  mind.  It  will  be  recalled  how  many  a  lecture  or 
sermon,  good  in  itself,  was  utterly  spoiled  because  the  hearers 
were  breathing  the  foul  air  of  an  unventilated  audience  room. 
Scientific  ventilation,  especially  during  the  winter,  would  add 
much  to  the  success,  happiness,  and  religious  enjoyment  of  many 
persons  who  are  morose,  depressed,  and  even  melancholic,  as 
the  result  of  their  voluntary  imprisonment  in  their  miserably 
ventilated  living  rooms. 

Oxygen  feeds  the  vital  fires  which  effectually  burn  up  the 
poisons  of  the  living  machine.  These  poisons  when  not  prop- 
erly burned  up  (oxidized)  prove  equally  powerful  in  the  work 
of  depressing  both  mind  and  body.  The  vast  majority  of  the 
toxins  of  disordered  metabolism  and  deranged  nutrition  prove 
to  be  mind  poisons  as  well  as  body  poisons.  Insanity  as  well  as 
paralysis  frequently  follows  in  the  wake  of  raging  fevers  and 
prolonged  infections. 

Considered  from  every  possible  standpoint,  mental  vigor  and 
moral  health  are  greatly  lessened  by  the  indoor  living  of  mod- 
ern civilization;  while  the  outdoor  life,  in  every  way,  supplies 
conditions  which  favor  the  highest  degree  of  mental  strength 
and  moral  efficiency. 

DEEP    BREATHING  AND   BRAIN   ACTION 

The  normal  action  of  the  lungs  has  much  to  do  with  the 
healthy  action  of  the  mind.  Deep  breathing  favors  deep  think- 
ing, while  the  shallow  breathers  are  condemned  to  inevitable 
shallow  thinking.     Healthy  brain  action  is  dependent  upon  the 


24  WORRY  AND  NERVOUSNESS 

normal  supply  of  good,  red  blood.  Deep  breathing  purines  the 
blood  and  favors  its  circulation  through  the  brain.  If  the  brain 
is  not  properly  nourished  with  pure  blood,  the  mind  is  directly 
influenced  and  greatly  crippled  in  its  operation. 

All  victims  of  despondency,  all  downcast  and  crestfallen 
people  are  shallow  breathers.  Deep  breathing  purifies  the  blood 
and  sends  it  tingling  through  the  blood  vessels  of  the  brain, 
where  it  washes  away  the  poisonous  excretions  and  nourishes 
the  nerve  cells  with  its  life-giving  qualities.  A  ventilated  and 
nourished  brain  cell  is  absolutely  essential  to  normal  and  satis- 
factory mental  action. 

There  can  be  little  doubt  that  bad  breathing  and  worry  go 
together.  Getting  rid  of  one  usually  helps  in  overcoming  the 
other.  Shallow  breathing  beclouds  the  mind  by  favoring  a  re- 
tention of  blood  poisons,  thereby  placing  heavy  and  unnecessary 
burdens  upon  the  moral  nature. 

PHYSICAL    EXERCISE    AND    MENTAL    ACTION 

More  or  less  body  work  is  indispensable  to  first-class  brain 
work.  Physical  exercise  increases  the  circulation,  favors  di- 
gestion, promotes  elimination,  in  fact  facilitates  all  those  bodily 
processes,  the  proper  performance  of  which  are  so  essential 
to  a  healthy  brain  and  a  vigorous  mind.  Body  work  favors  deep 
breathing  and  deep  breathing  promotes  mental  action. 

Physical  exercise  greatly  aids  in  the  burning  up  of  bodily 
poisons  and  thus  relieves  the  mind  from  the  depression  which 
so  surely  results  from  the  accumulation  of  these  toxic  sub- 
stances in  the  blood  stream.  Systematic  exercise  will  do  much 
to  help  in  the  acquisition  of  a  pleasant  disposition  and  an  agree- 
able temperament.  Regular  exercise  —  a  daily  sweat  —  will 
contribute  much  to  mental  peace  and  the  enjoyment  even  of  one's 
religion. 

Overworking  the  body  produces  mental  weariness,  as  well 
as  physical  fatigue.  The  industrial  slave,  toiling  in  the  sweat 
shop,  exhibits  equal  evidence  of  mental  deterioration  and  physi- 
cal disease.  The  abuse  of  the  physical  powers  inevitably  reacts 
in  the  lessening  of  the  mental  vigor.  Muscle,  mind,  and  morals 
are  all  inter  related. 


INFLUENCE  OF  THE  PHYSICAL  HEALTH        25 

THE  MIND  AS  INFLUENCED  BY  THE  DIGESTION 

The  stomach  probably  exerts  a  greater  influence  over  the 
mind  than  any  other  physical  organ,  except  the  brain.  At  cer- 
tain times,  when  the  mind  is  almost  dethroned  by  a  distracting 
pain  in  the  cranium,  the  sufferer  could  truly  be  said  to  have  a 
"  stomach  ache  "  in  the  head.  The  stomach,  as  .the  portal  of 
entry  for  all  nourishment  of  the  body,  is  able  to  contribute  much 
either  for  or  against  the  mental  health  and  the  moral  happiness 
of  the  individual.  The  nerve  which  so  abundantly  supplies 
the  stomach,  liver,  lungs,  and  heart  — the  pneumogastric  nerve 
—  also  sends  branches  to  the  meninges,  the  covering  membrane 
of  the  brain. 

Many  persons  who  are  regarded  as  cross  and  crabbed,  who 
are  looked  upon  as  possessing  an  unbearable  disposition,  whose 
minds  are  commonly  regarded  as  altogether  ignoble  and  cruel  — 
are  merely  suffering  from  a  chronic,  dyspeptic  grouch;  and  it 
will  be  a  hard  matter  for  orthodox  religion  or  any  of  its  twen- 
tieth century  counterfeits,  or  any  other  genuine  or  fraudulent 
system  of  mental  healing,  to  relieve  such  persons  of  their  mental 
disorders  until  the  stomach,  liver,  and  bowels  are  set  in  order. 

A  sour  stomach  usually  means  a  sour  disposition.  Intestinal 
fermentation  commonly  ends  in  intellectual  fermentation.  In 
order  to  sweeten  up  the  mental  process,  we  must  sweeten  up  the 
digestive  process. 

Many  failures  in  business,  college,  family  life,  and  religion, 
if  the  facts  were  known,  could  be  rightfully  charged  up  to  dis- 
ordered nutrition  —  dyspepsia  and  constipation.  It  is  altogether 
impossible  to  have  peace  in  the  head  and  war  in  the  stomach. 
Coarse  eating  and  fine  thinking  are  incompatible. 

BILIOUSNESS    AND    BRAIN    BEHAVIOR 

Biliousness  is  a  disease  by  no  means  limited  to  the  body. 
When  one  is  bilious,  the  brain  is  bilious,  the  mind  is  forced  to 
operate  through  a  bilious  brain  and  over  a  bilious  nervous  sys- 
tem, and  that  is  exactly  why  one  looks  bilious,  acts  bilious,  and 
talks  bilious  —  the  brain  is  jaundiced  as  well  as  the  skin. 

The  liver  is  the  body's  poison-destroyer  —  the  metabolic  gar- 
bage crematory  —  and  when  it   fails  properly  to  do  its  work. 


26  WORRY  AXD  NERVOUSNESS 

when  it  is  overworked,  lazy,  or  torpid,  the  blood  is  literally 
flooded  with  toxins  and  poisons,  and  soon  the  brain  becomes 
torpid,  the  mind  lazy  and  the  thoughts  sordid. 

Even  the  powers  of  memory  are  directly  influenced  by  indi- 
gestion, biliousness,  and  acidity  of  the  blood.  Many  persons 
suffering  from  dyspepsia  and  indigestion,  supposing  their  mem- 
ory to  be  failing  from  old  age,  have  found  their  mental  energies 
restored  and  their  thinking  powers  renewed,  after  the  success- 
ful treatment  of  their  distressing  stomach  difficulties  and  liver 
disorders. 

THE    INFLUENCE    OF    EATING    ON    THINKING 

While  we  acknowledge  as  true  the  proverb,  "  As  a  man  think- 
eth,  so  is  he,"  we  are  compelled  also  to  recognize  the  truthful- 
ness of  that  old  German  saying,  "  As  a  man  eateth,  so  is  he." 

Maximum  mental  efficiency  demands  that  intelligent  attention 
be  given  to  the  diet.  Balanced  thinking  goes  hand  in  hand 
with  balanced  eating.    Pure  food  is  a  direct  aid  to  pure  thoughts. 

Overeating,  hasty  eating,  and  the  eating  of  indigestible  foods, 
all  detract  from  brain  power  and  mental  efficiency.  The  animal 
world  —  a  cow  for  instance  —  can  spend  all  its  nervous  energy 
and  vital  strength  in  the  work  of  digesting  food.  Animals  are 
able  to  keep  the  stomach  working  all  day  long.  They  seldom  suf- 
fer from  indigestion  or  dyspepsia.  The  animal  has  only  a  physi- 
cal life  to  lead ;  but  man  is  a  mental  being,  a  moral  creature,  an 
intelligent  animal,  with  a  social  career  to  carve  out  and  industrial 
battles  to  fight ;  and,  therefore,  the  human  animal  must  plan  to 
conserve  its  nervous  energy  and  physical  powers  so  as  properly 
to  support  its  intellectual  activities  in  the  arena  of  mind  and 
morals  —  to  enable  the  man  successfully  to  perform  in  the 
theater  of  society  and  commerce. 

Fiery  foods  —  foods  which  are  hot  when  they  are  cold  —  not 
only  irritate  and  inflame  the  stomach,  but  when  carried  to  the 
brain  in  the  blood  stream,  favor  the  production  of  fiery  thoughts. 

THE    BLOOD    STREAM     AND    THE     MIND 

It  is  self-evident  that  brain  action  is  dependent  upon  heart 
action.     The  mind  is  bound  to  be  affected  by  circulatory  dis- 


INFLUENCE  OF  THE  PHYSICAL  HEALTH        27 

turbances,  elevation  of  the  blood-pressure,  or  congestion  of  the 
blood  in  any  organ  of  the  body.  Diseases  of  the  blood,  such 
an  anaemia,  produce  anaemia  of  the  brain  and  emaciation  of  the 
mind. 

Elevation  of  the  blood-pressure  is  often  associated  with  de- 
pression of  the  thoughts.  An  unusually  low  blood-pressure  is 
usually  associated  with  the  mental  states  characterizing  neuras- 
thenia and  brain  fag.  The  various  drugs,  such  as  tobacco  and 
cocaine,  which  raise  the  blood-pressure,  as  well  as  the  alcohol 
and  morphine  group,  which  lower  the  pressure,  are  all  power- 
ful in  their  deteriorating  effect  upon  the  mind.  In  fact,  all 
states  of  systemic  poisoning  or  auto-intoxication,  result  in  more 
or  less  derangement  of  the  mental  action. 

The  myriads  of  microbes  which  inhabit  the  large  intestine 
of  man  are  often  responsible  for  much  of  the  mental  sluggish- 
ness and  moral  depression  from  which  many  persons  suffer. 
When  these  germs  are  too  long  retained  in  the  bowel  —  when 
their  number  is  greatly  increased  by  gormandizing,  constipation, 
or  a  too  high  protein  diet  —  there  is  increased  production  and 
absorption  of  toxins  which  are  responsible  for  many  disturbances 
of  the  mind  and  body,  including  sleeplessness,  bad  breath,  brown- 
ish tint  of  the  skin,  headache,  mental  inaction,  loss  of  memory, 
and  moral  despondency. 

METABOLISM  AND  MIND 

Many  strong  minds,  vigorous  intellects,  are  held  down  and 
handicapped  by  the  crippled  assimilative  powers  of  the  physical 
body.  Any  practice  which  favors  food  assimilation  —  thorough 
mastication  of  the  food  and  all  other  dietetic  helps  —  in  the  end 
will  prove  of  great  value  in  strengthening  the  mind  and  increas- 
ing the  health-seeker's  self-control. 

In  chronic  indigestion  and  stomach  trouble,  with  their  re- 
sultant starvation  and  anaemia,  we  have  brain  starvation  — 
mental  emaciation.  Many  a  giant  intellect  has  been  effectually 
starved  out  and  prematurely  killed  by  the  combined  terrors  of 
dyspepsia  and  the  poisons  absorbed  as  a  result  of  chronic  con- 
stipation. 

Both  physicians  and  criminologists  are  coming  more  and  more 


28  WORRY  AND  NERVOUSNESS 

to  believe  that  there  is  a  direct  relation  between  decomposing 
food  in  the  digestive  apparatus  and  mental  perversity ;  the  re- 
sults are  variously  exhibited  and  extend  all  the  way  from  vio- 
lent outbursts  of  temper  down  to  criminal  depredations  and 
brutal  tendencies. 

ELIMINATION   AND  BRAIN   ACTION 

Healthy,  vigorous  brain  action  is  dependent  upon  normal 
elimination  of  body  wastes;  and  normal  elimination  of  wastes 
is  dependent  largely  upon  systematic  water-drinking  and  regu- 
lar bathing.  Bathing  is  an  antidote  for  the  wearing  of  clothes 
and  the  sedentary  life  of  modern  civilized  nations. 

The  proper  action  of  the  kidneys  in  the  elimination  of  poisons, 
and  the  liver  in  their  destruction,  is  essential  to  the  healthy  and 
normal  action  of  the  mind.  A  cloudy,  dingy  skin  usually  means 
cloudy  thinking. 

There  is  a  direct  relation  between  skin  action  and  brain  action. 
When  the  skin  is  pale  and  anaemic,  the  brain,  as  a  rule,  is  con- 
gested and  sluggish.  The  red  glow  of  the  skin  is  usually  asso- 
ciated with  mental  vigor,  while  the  pale  skin  is  not  infrequently 
accompanied  by  puny  thinking. 

REST   AND   RECREATION    IN    RELATION   TO  THE   MIND 

The  accumulation  of  energy  granules  in  the  neuron,  the  re- 
cuperation of  the  depleted  vitality  of  the  nervous  system,  the 
restoration  of  the  brain's  power  to  respond  to  the  dictates  of  the 
mental  powers,  are  all  dependent  upon  regular  rest  and  refresh- 
ing sleep.  Loss  of  sleep  quickly  shows  its  reaction  upon  the 
mind,  dulling  the  intellect,  dimming  the  mental  vision,  and  de- 
stroying even  the  moral  concepts. 

Regular  recreation  and  an  annual  vacation  are  indispensable  to 
first-class  brain  work.  A  regular  rest  day,  once  a  week,  and 
even  a  half  holiday  in  the  middle  of  the  week,  are  both  of  great 
value  in  producing  strong  and  healthy  mind  control. 

BODY   DISEASE    AND    BRAIN    DISORDERS 

Attention  should  also  be  called  to  the  fact  that  all  definite 
physical  diseases  result  in  more  or  less  derangement  of  the  mind. 


IXFLUENCE  OF  THE  PHYSICAL  HEALTH        29 

In  all  acute  fevers  and  infectious  diseases  the  mental  powers  are 
enfeebled,  the  mind  is  more  or  less  distorted,  the  symptoms  rang- 
ing from  mild  derangement  up  to  raving  delirium.  The  major- 
ity of  poisonous  disease  toxins  are  alike  disturbing  to  the  mind 
and  body. 

Typhoid  fever  and  many  other  serious  infections  predispose 
to  mental  disturbances,  and  are  occasionally  followed  by 
insanity.  Pellagra  has  a  terminal  stage  which  closely  borders 
on  the  insane  state.  Malaria  not  only  racks  the  body,  but  also 
markedly  affects  the  mental  activities. 

The  social  diseases  constituting  the  great  black  plague,  of  which 
syphilis  is  chief,  not  only  affect  the  body,  but  also  react  upon  the 
mind,  even  to  the  point  of  producing  tumors  and  softening  of  the 
brain. 

Heart  and  lung  diseases  always  affect  the  mind,  the  former 
producing  unusual  fear  and  depression,  while  the  latter  is  charac- 
terized by  a  fatal  optimism.  The  mental  activity  is  also  in  meas- 
ure influenced  by  most  of  the  chronic  diseases,  such  as  rheuma- 
tism and  gout,  not  only  because  of  the  pain  associated  with  these 
afflictions,  but  also  because  of  the  toxins  and  poisons  circulating 
in  the  blood  which  are  probably  primarily  responsible  for  these 
disorders. 

That  the  mind  is  influenced  by  the  body  is  shown  by  both 
extremes  of  bodily  weight.  There  can  be  little  question  that 
obese,  abnormally  fat  persons,  as  well  as  the  thin,  emaciated  and 
cadaverous,  have  their  peace  of  mind  and  intellectual  activity 
more  or  less  interfered  with,  as  the  result  of  their  bodily  state. 

PHYSICAL  CONDITIONS  AFFECTING  THE  CHILD'S  HEALTH 

When  a  child  has  rickets  of  the  bones,  his  physical  condition 
unfavorably  affects  the  mental  development.  In  other  words, 
the  child  with  rickets  is  rickety  in  mind  as  well  as  in  body. 

Recent  investigations  afford  positive  proof  that  adenoids  in  the 
child  interfere  with  the  development  of  the  brain,  and  thus  more 
or  less  permanently  cripple  the  mentality  of  the  child.  Various 
ether  minor  afflictions  of  childhood  may  similarly  affect  the  men- 
tal development,  such  as  chronic  tonsilitis,  chronic  earache,  and 
many  other  maladies. 


3o  WORRY  'AND  NERVOUSNESS 

No  one  will  seriously  question  the  fact  that  pain  invariably 
exerts  a  deleterious  influence  upon  the  mind.  Intellectual  activ- 
ity and  mental  usefulness  are  restricted  or  well-nigh  destroyed 
by  severe  or  long  continued  pain  in  any  part  of  the  body,  result- 
ing from  any  cause  whatsoever. 

Minor  disturbances  or  bony  growths  in  the  nose  may  result  in 
persistent  chronic  headaches,  which  greatly  interfere  with  peace 
of  mind  and  mental  usefulness.  We  have  known  of  persons 
suffering  from  headache  for  years,  who  were  immediately  re- 
lieved by  the  removal  of  a  bony  growth  from  the  nose,  or  by  the 
straightening  of  a  crooked  nasal  septum. 

OLD   AGE   AND   THE    DUCTLESS    GLANDS 

There  can  be  no  more  marked  illustration  of  the  effect  of  the 
body  upon  the  mind  than  in  the  case  of  arteriosclerosis,  or  hard- 
ening of  the  arteries.  This  harbinger  of  old  age  not  only  results 
in  producing  those  familiar  manifestations  of  physical  decay 
which  characterize  senility,  but  they  also  result  in  producing  a 
state  of  comparative  brain  starvation.  The  mind  is  under-nour- 
ished, all  the  mental  powers  are  enfeebled,  the  memory  is  weak- 
ened and  we  are  brought  face  to  face  with  that  pathetic  picture 
of  increasing  mental  weakness  commonly  denominated  "  second 
childhood." 

There  can  be  little  doubt  that  the  various  internal  secreting 
glands  such  as  the  pituitary  body,  thymus  gland,  thyroid  gland, 
suprarenal  gland,  the  sexual  glands,  etc.,  are  all  concerned  in 
powerfully  influencing  the  mind,  temperament,  and  disposition. 
Witness  the  mental  inaction,  the  idiotic  expression  of  the  cretin 
—  the  child  whose  thyroid  gland  is  not  functionating  normally. 
Observe  the  marked  mental  and  temperamental  changes  which 
result  from  the  disease  or  removal  of  the  sexual  glands,  by  de- 
priving the  brain  of  the  influence  of  their  internal  secretions. 

The  effect  of  the  various  nervous  diseases  upon  the  mind  is 
self-evident.  Paralysis,  various  spinal  diseases,  neuritis  and 
neuralgias  all  very  directly  and  markedly  affect  the  mind.  Vic- 
tims of  paraesthesia  —  those  who  feel  various  pricking,  burning 
or  itching  sensations  in  different  parts  of  the  body  —  are  often 
driven  almost  to  distraction  by  these  abnormal  manifestations. 


INFLUENCE  OF  THE  PHYSICAL  HEALTH        31 

Mental  action  is  even  interfered  with  by  eye  strain  and  many 
other  common  disorders  affecting  some  part  of  the  nervous  sys- 
tem. 

In  fact,  every  physical  practice  of  the  individual  and  the 
entire  life  conduct,  react  either  favorably  or  unfavorably  upon 
the  mind.  The  young  man  may  pass  on  gayly  and  heedlessly 
sowing  his  wild  oats  in  the  seedtime  of  youth,  but  in  the  harvest 
time  of  after  life  not  only  must  the  body  pay  a  physical  penalty 
for  the  follies  of  ignorance  and  sin,  but  the  mind  also  is  forced 
to  share  in  the  painful  and  sorrowful  harvest. 

Even  worry  is  often  caused  by  the  bodily  state,  there  being  a 
whole  group  of  worry  causes  which  may  properly  be  termed 
physical  causes.  These  will  be  more  fully  considered  in  the 
chapters  devoted  to  worry. 

SUMMARY    OF    THE    CHAPTER 

1.  The  mind  is  recognized  as  holding  the  balance  of  control 
over  numerous  physical  processes ;  nevertheless,  almost  equal 
recognition  must  be  accorded  the  power  of  the  bodily  state  in  its 
influence  over  the  mental  operations. 

2.  While  sunshine  and  good  weather  elevate  the  emotions, 
fogs  and  cloudy  weather  universally  depress  the  physical  func- 
tions and  decrease  the  mental  operations. 

3.  Fresh  air,  ventilation,  and  breathing  are  all  concerned  in 
the  development  and  operation  of  the  intellectual  powers.  Oxy- 
gen is  indispensable  to  the  operation  of  mind  and  body. 

4.  Shallow  breathers  are  nearly  always  despondent  and  easily 
discouraged.    Deep  breathing  is  conducive  to  deep  thinking. 

5.  Regular  body  work  is  essential  to  first-class  brain  work. 
Physical  idleness  "leads  to  mental  indolence.  Physical  develop- 
ment —  within  physiological  limits  —  favors  mental  develop- 
ment ;  on  the  other  hand,  overwork  of  the  body  leads  to  mental 
fatigue  as  well  as  physical  weariness. 

6.  The  stomach,  digestion,  and  dyspepsia  all  exert  a  profound 
influence  on  the  mental  state.  Sour  stomach  usually  culminates 
in  a  sour  disposition.  It  is  impossible  to  have  peace  in  the  head 
and  war  in  the  stomach. 

7.  Biliousness  invariably  deteriorates  brain  action;  the  brain 
is  jaundiced  as  well  as  the  body.  When  the  liver  is  torpid  the 
mind  soon  follows  suit. 

8.  Thinking  is  directly  related  to  eating.  Gluttony  and  intem- 
perance react  disastrously  to  the  weakening  of  the  mental 
powers.     Table  habits  powerfully  influence  thinking  habits. 


32  WORRY  AXD  NERVOUSNESS 

9.  The  blood  is  the  life  —  the  life  of  mind  as  well  as  body. 
Mental  action  is  immediately  influenced  by  fluctuations  in  blood 
pressure  or  alterations  of  blood  quality.  Bodily  anaemia  is 
usually  accompanied  by  intellectual  anaemia. 

10.  Self-poisoning  or  auto-intoxication  is  not  infrequently 
mistaken  for  moral  perversity  and  mental  insubordination.  Con- 
tamination of  the  circulating  fluids  of  the  body  results  in  pervert- 
ing the  mental  powers. 

11.  Many  a  giant  intellect  has  been  starved  out  or  killed  by  the 
combined  terrors  of  dyspepsia  and  constipation.  There  is  a 
direct  relation  between  putrefying  footstuff  in  the  digestive 
canal,  and  perversity  of  mental  action  in  the  brain. 

12.  Bathing  is  an  antidote  for  clothes  and  sedentary  living. 
Elimination  is  essential  to  healthy  thinking.  There  is  a  direct 
relation  between  skin  action  and  brain  action. 

13.  All  acute  diseases  and  all  chronic  disorders  operate  to 
weaken,  pervert,  derange,  or  disease  the  mental  action.  There  is 
not  a  single  physical  disease  that  does  not  react  unfavorably  upon 
the  mind.  There  can  be  no  disorder  of  body  function  without 
more  or  less  derangement  of  mind  action. 


CHAPTER   IV 
POWER  OF  THE  MIND  OVER  THE  BODY* 

IT  HAS  long  been  recognized  that  the  mental  process  carried 
on  in  the  brain  exerted  more  or  less  of  an  influence  upon  the 
physical  functions  carried  on  by  the  body;  and  full  recognition 
has  been  given  to  the  ability  of  the  brain  to  direct  the  vol- 
untary muscles  in  the  performance  of  mechanical  work,  and  to 
control  numerous  other  voluntary  and  commonly  performed 
actions;  but  not  until  recently  was  it  fully  understood  just  how 
far  the  mental  attitude  was  responsible  for  or  could  directly 
influence  the  numerous  complicated  and  delicate  functions  of 
the  body  which  are  involved  in  the  maintenance  of  health  and 
the  prevention  of  disease.  A  French  philosopher,  Guyau,  has 
well  said:    "  He  who  does  not  act  as  he  thinks,  thinks  badly." 

Can  the  mind  in  and  of  itself  actually  bring  disease  upon  the 
body?  Do  we  really  have  imaginary  diseases?  Can  the  mind 
actually  cure  disease?  Could  the  mind  really  remove  a  physical 
disorder? 

Likewise,  questions  on  the  other  side  of  the  issue:  Can  a 
physical  disorder  produce  a  mental  disease?  Can  a  sick  body 
produce  a  sick  mind?  These,  and  many  similar  questions  have 
engaged  the  attention  of  philosophers,  physicians,  and  physiolo- 
gists of  the  past,  and  will,  undoubtedly,  continue  to  engage  their 
attention  in  the  future. 

ANCIENT   TEACHINGS 

Past  teaching  respecting  the  influence  of  the  mind  upon  the 
body,  has  been  clouded  and  distorted  by  the  errors  of  supersti- 


*  For  a  more  complete  discussion  of  the  influence  of  the  emotions 
on  the  physical  organism,  the  reader  is  referred  to  the  Author's  work, 
The  Physiology  of  Faith  and  Fear,  chapters  xi  —  xxm. 

33 


34  WORRY  AXD  XERVOUSXESS 

tion,  the  inaccuracies  of  ignorance,  and  the  exaggerations  of 
fanatical  extremists,  whose  prejudiced  observations  and  reports 
were  more  or  less  colored  by  commercial  motives  or  sectarian 
enthusiasm.  And  so  it  was  little  wonder  that  teaching  respect- 
ing mental  healing  grew  into  a  mass  of  religious  contradictions, 
unreliable  observations,  and  groundless  assertions.  It  has  re- 
quired much  painstaking  labor  on  the  part  of  modern  physiolo- 
gists and  psychologists  to  clear  away  this  accumulation  of  rub- 
bish and  ignorance,  and  lay  a  scientific  foundation  for  a  rational 
system  of  mental  hygiene  based  upon  the  known  laws  of  mind 
and  matter. 

Xot  in  all  cases  do  the  mind  and  body  react  upon  one  another 
as  might  be  thought,  an  observation  well  stated  by  Dubois,  who 
wrote : 

First  of  all.  that  between  the  physical  condition  and  the  mental 
condition,  there  is  no  direct  and  necessary  bond,  entailing  a  constant 
parallelism  between  the  physical  health  and  that  of  the  mind.  On 
the  one  hand  we  see  weak,  feeble,  emaciated  diseases,  presenting  no 
symptom  of  neurasthenia  or  psychasthenia ;  these  are  healthy  minds 
in  sick  bodies ;  conversely  one  sees  the  various  disorders  of  the 
psychopathies  succeeding  each  other  in  men  of  herculean  frame, 
enjoying  excellent  physical  health,  and  who  have  not  been  subjected 
to  any  marked  debilitating  influence.  It  is  therefore  false  immedi- 
ately to  conclude  the  mental  integrity  from  the  physical  health,  and 
always  to  seek  in  the  body  the  cause  of  the  psychic  disequilibrium. 

HOW    THE    MIND    INFLUENCES    THE    BODY 

The  scientific  revelations  of  the  last  century  have  taught  us 
that  in  the  study  of  health  and  disease  we  must  come  to  look 
upon  man  as  a  whole  —  as  a  unit  —  as  an  organized  community 
of  living  cells.  Each  little  fellow  is  a  distinct  and  separate 
being,  with  a  life  of  its  own  to  live,  and  with  its  special  individ- 
ual work  to  carry  on  as  long  as  it  lives.  We  are  coming  more 
and  more  to  understand  that  the  health  and  happiness  or  the 
disease  and  distress  of  any  cell  or  group  of  cells,  is  in  a  measure 
shared  by  all  the  other  cells  composing  the  body's  common- 
wealth. That  is,  disorder  in  any  cell  or  organ  of  the  body,  be  it 
brain,  liver,  or  lung,  must  in  some  measure  unfavorably  affect 


POWER  OF  THE  MIND  OVER  THE  BODY         35 

every  other  cell  of  the  body.  If  one  member  suffers,  all  must 
suffer  more  or  less. 

This  intimate  association,  this  close  interrelationship  of  all 
the  cells  of  the  human  body,  is  effected  through  two  separate 
and  distinct  channels:  the  circulatory  system  and  the  nervous 
system. 

1.  The  circulatory  system  —  chemical  messages.  Every  cell 
of  the  physical  economy  is  constantly  giving  out  from  its  own 
tiny  body  certain  secretions  and  excretions  formed  within  itself, 
which  are  gathered  up  by  the  lymph,  and  after  being  admixed 
with  the  blood  stream,  in  a  diluted  form,  are  in  time  carried  to 
every  other  cell  of  the  body.  This  constant  interchange  of  cel- 
lular products  creates  a  channel  by  which  any  cell  or  group  of 
cells  is  able  to  send  chemical  messages  to  any  other  cell  or  group 
of  cells  in  the  body;  and  in  the  aggregate  it  turns  the  circulat- 
ing fluids  of  the  body  into  a  great  chemical  messenger  carrying 
the  messages  from  any  cell  to  every  and  all  other  cells  of  the 
body. 

Many  important  bodily  functions,  we  now  know,  are  carried  on 
in  cooperation  and  coordination  by  means  of  these  chemical 
messages  which  are  carried  from  one  part  of  the  body  to  an- 
other by  the  body's  circulating  fluids.  We  now  know  that  the 
pancreatic  juice  is  secreted  in  obedience  to  just  such  a  chemical 
message,  which  is  sent  out  from  the  stomach  and  bowel. 

This  "secretin"  (as  a  class  these  substances  are  called  hor- 
mones) has  been  collected  and  when  it  is  experimentally  injected 
into  the  blood  stream  of  an  animal,  it  never  fails  to  produce  an 
immediate  secretion  and  flow  of  both  bile  and  pancreatic  juice. 

It  must  be  evident  then,  that  by  means  of  numerous  chemical 
messengers  various  portions  of  the  body  are  able  profoundly  to 
influence  other  parts  of  the  body  —  that  is,  one  organ  of  the  body 
may  directly  exert  an  inhibiting  or  a  stimulating  influence  upon 
another  organ.  In  this  way,  disease  in  any  one  organ  of  the 
body  results  in  producing  more  or  less  of  a  diseased  state  in 
some  or  all  of  the  organs  of  the  body;  and  so  it  is  literally  true, 
that  disease  in  any  part  of  the  body  does  result  in  more  or  less 
derangement  of  the  health  of  the  entire  organism. 

Many  cases  of  mental  depression  owe  their  existence,  primar- 


36  WORRY  AND  NERVOUSNESS 

ily,  to  the  circulation  in  the  blood  of  certain  poisons  which  have 
a  tendency  to  raise  the  blood-pressure  and  at  the  same  time  lower 
the  mental  and  moral  courage  of  the  individual.  But  powerful 
as  are  these  means  of  chemical  communication  between  the  cells 
of  the  body,  we  have  a  still  more  important  and  intimate  means 
of  intercommunication  between  the  various  cells  and  organs  of 
the  body. 

2.  The  nervous  system  —  mental  messages.  Nearly  all  neurons 
or  nerve  cells  possess  two  or  more  branches.  One  of  these 
branches  carries  impulses  from  the  nerve  cell  to  other  nerve  cells 
or  to  special  structures  such  as  the  muscles,  while  the  other 
branch  carries  impressions  to  the  nerve  cell  from  the  skin  and 
other  organs  of  sensation  as  well  as  from  other  nerve  cells. 

It  is  estimated  that  there  are  over  two  billions  of  living  nerve 
cells  in  the  human  brain  and  spinal  cord,  not  to  mention  the  un- 
told millions  of  cells  which  are  found  in  the  sympathetic  nervous 
system  with  its  large  central  brain  in  the  abdomen  —  the  solar 
plexus. 

It  must  be  very  clear  that  by  means  of  these  living  wires — ■ 
these  relays  of  cables  which  run  to  and  from  the  brain,  and 
which  branch  and  re-branch  until  practically  every  active  cell  in 
the  human  body  is  supplied  with  its  tiny  little  nerve  —  through 
this  channel  of  the  nervous  system,  any  one  part  of  the  body  can 
almost  instantaneously  influence  any  or  every  other  part  of  the 
body  for  weal  or  woe. 

Let  a  person  when  quite  hungry  either  smell  or  taste  savory 
food.  These  pleasant  impressions  of  taste  and  smell  are  quickly 
carried  to  the  nervous  headquarters  —  the  brain  —  from  whence 
orders  are  immediately  despatched  to  the  stomach  to  secrete  the 
necessary  gastric  juice  to  digest  the  meal  about  to  be  eaten,  and 
in  obedience  to  this  mental  message  which  the  mind  sends  down 
from  the  brain,  there  begins  to  be  poured  out  into  the  stomach 
in  about  four  and  a  half  minutes,  an  abundance  of  strong  gastric 
juice,  which,  in  both  quantity  and  quality,  is  just  adapted  to  the 
appetite  and  the  digestion  of  the  food  which  was  instrumental  in 
provoking  its  secretion. 

Uncontrolled  emotion  may  be  compared  to  a  river  which  has 
overrun  its  banks,  spreading  itself  everywhere  over  the  physical 


POWER  OF  THE  MIXD  OVER  THE  BODY          $7 

domain  in  devastating  torrents,  carrying  trouble  to  every  vital 
organ  and  sensory  mechanism  of  the  body.  This  deluge  of  emo- 
tion not  only  creates  functional  nervous  trouble  by  the  intensity 
of  the  mental  representations  which  it  produces,  but  it  engenders, 
by  exhausting  the  nerve  centers,  real  sensations,  disagreeable  or 
painful,  which  furnish  new  grounds  for  disturbing  the  mind  of 
the  patient,  and  thus  effectually  giving  rise  to  new  fears  and 
other  vexatious  auto-suggestions. 

The  human  imagination  possesses  almost  life  and  death  power 
as  shown  by  the  following  authentic  newspaper  clipping : 

IMAGINATION    NEARLY    COSTS    MAN'S    LIFE 

,  Cal.,  Oct.   18.     Imagination  nearly  killed  Rex  L.     He  ap- 


plied to  a  druggist  for  a  vial  of  poison  and  his  actions  aroused  the 
suspicion  that  he  intended  to  take  his  life.  The  druggist  gave  him 
a  harmless-  fluid. 

He  wrote  a  farewell  note  to  his  wife  and  drank  the  liquid.  In 
a  few  minutes  he  was  suffering  all  the  agonies  of  poisoning.  He 
was  rushed  to  the  county  hospital,  where  it  was  said  today  it  would 
take  a  week  for  him  to  recover  from  the  shock.  Hospital  physicians 
say  the  illusion  that  he  was  suffering  from  the  effects  of  poisoning 
actually  had  brought  the  man  to  the  brink  of  death. 

POWER    OF   THE    EMOTIONS    OVER   THE    CIRCULATION 

Under  the  influence  of  faith  and  its  associated  optimistic  state 
of  mind,  the  strength  of  the  heartbeat  is  strong,  normal,  and 
natural.  Unusual  mental  buoyancy  may  even  increase  the  heart 
strength.  The  vigor  of  the  heart  action  increases  hand  in  hand 
with  the  development  of  courage  and  the  acquisition  of  confi- 
dence. On  the  other  hand,  fear  and  other  phases  of  the  mental 
state  bordering  on  pessimism  not  infrequently  tend  actually  to 
decrease  the  strength  of  the  heart's  action.  Fear  unfailingly 
demoralizes  the  cardiac  functions  and  greatly  weakens  the  power 
of  the  heartbeat.  (Fig.  3,  c.)  Joy  always  increases  the  strength 
of  the  heart  action,  while  terror  never  fails  greatly  to  depress 
the  heart,  after  a  very  brief  initial  period  of  excitability  and 
rapid  action.  The  cardiac  rhythm  is  greatly  influenced  by  the 
mental  state,  even  to  the  point  of  producing  palpitation. 

The  mental  state  also  exerts  considerable  influence  upon  the 


38  WORRY  AND  NERVOUSNESS 

heart's  strength  by  determining  the  length  of  the  pause  between 
the  heartbeats.  Faith  exerts  a  favorable  influence  upon  the 
heart  rate  and  rhythm  by  encouraging  a  natural  and  adequate 
rest  between  beats,  thus  enabling  the  heart  to  keep  up  its  normal 
energy,  and,  in  case  of  the  weak  heart,  actually  to  gain  in 
strength.  In  this  way  faith  actually  increases  the  endurance  of 
the  heart  under  stress  and  strain.  Determination  and  courage 
are  even  able  to  postpone  heart  failure  when  the  patient  is  at  the 
very  point  of  death. 

When  the  mind  is  moving  in  a  natural  and  normal  channel, 
the  small  capillaries  of  the  skin  and  internal  organsxexecute  a 
rhythmic,  milking  movement,  which  sends  the  blood  bounding 
along  through  its  channels.  This  action  of  the  capillaries  is  of 
great  aid  to  the  heart,  in  fact  it  is  known  in  medical  science  as 
the  "  peripheral  heart."  Xext  to  hydrotherapy  and  massage,  the 
mental  state  of  the  patient  probably  has  more  to  do  with  con- 
trolling the  circulation  of  the  blood  than  any  other  single  in- 
fluence which  can  be  brought  to  bear  upon  the  human  body. 

Careful  observations  and  experiments  go  to  show  that  by  con- 
tinuously concentrating  the  mind  on  one  arm,  the  surface  tem- 
perature of  that  member  can  actually  be  raised  considerably  above 
that  of  the  other  arm.  This  rise  in  temperature  signifies  the  in- 
creased accumulation  of  blood  in  the  part  —  local  congestion. 

Colonel  Townsend  was  an  Englishman  who  possessed  the 
power  of  voluntarily  causing  a  cessation  of  his  heart  beat.  He 
was  able  to  remain  in  a  state  of  apparent  death  for  a  period  of 
half  an  hour.  Dr.  Cheyne  and  Dr.  Baynard,  who  were  witnesses 
of  such  an  act,  state  that  they  were  unable  to  perceive  any  pulse 
or  heart  beat  nor  any  respiratory  movement,  and  that  a  clean 
mirror  held  to  Townsend's  mouth  did  not  become  dimmed.  The 
physicians  feared  Townsend  was  dead,  but  after  half  an  hour 
the  heartbeat  slowly  returned,  respiration  set  in,  and  the  body 
began  to  move. 

INFLUENCE   OF   THE    MIND   ON   VITAL   RESISTANCE 

There  can  now  be  little  question  of  the  fact  that  a  vigorous, 
happy  mental  state,  by  its  influence  on  both  the  nervous  and 
circulatory  systems,  tends  to  increase  the  defensive  activity  of 


a.  He  likes  chocolate.  Be- 
tween i  and  2  the  subject 
tasted  a  piece  of  chocolate. 
The  lower  curve  shows  the 
steady  increase  in  the  arm 
circulation. 


L^jM^—^^ 


- 


tzz^ 


^A 


■  ■'-■'-'■•■.      . 


c.  The  result  of  shock.  At 
b  a  revolver  was  fired  be- 
hind the  unsuspecting  subject. 
Tremor  caused  the  pencil 
describing  the  curves  to  run 
off  the  paper,  beginning  to 
draw  again  at  c. 


/^^ 


VWVWVV^-WVlVYv*/ 


e.  Do  you  hold  your  breath 
to  "'  do  a  stun  "  ?  The  person 
did  in  this  case.  He  worked 
on  his  problem  from  x  to  x. 
During  this  time  his  breath- 
ing, shown  by  upper  line, 
became  shallow. 


b.  He  abominates  quinine. 
He  tasted  quinine  between  i 
and  2.  The  volume  of  blood 
in  arm  shrank,  while  the 
pulse  beats  became  rapid. 


d.  Hon'   brai  ham- 

pers hand  work.  The  vertical 

lines  represent  the  lifting 
height  of  a  single  finger. 
From  1  to  t  the  subject  had 
to  multiply  657  by  34.  Note 
how  ithe  muscular  power  is 
lessened. 


aj  wj 


f.  W  h  y  "  multiplication 
means  vexation."  Work  on 
the  problem  was  accompanied 
by  a  notable  rise  of  the 
brain-volume,  and  an  in- 
crease in  the  height  of  the 
individual  pulse  beats 


Fig.  3.  How  the  Body  Betrays  the  Mir. 

(After  Lehmann) 


POWER  OF  THE  MIND  OVER  THE  BODY         39 

the  white  blood  cells.  By  favoring  the  healthy  circulation  of  the 
blood,  the  white  cells  are  protected  from  many  influences  which 
otherwise  would  depress  and  decrease  their  germ-destroying  and 
life-saving  activities.  It  is  well  known  that  any  influence  which 
causes  a  vigorous  movement  of  the  blood  stream  enhances  their 
action  in  the  work  of  destroying  the  microbes  of  disease.  Fear 
depresses  the  circulation  and  favors  the  accumulation  of  meta- 
bolic acid  poisons  in  the  body,  which  condition  not  only  de- 
creases the  activities  of  the  white  blood  cells  in  their  work  of 
destroying  germs,  but  actually  tends  to  increase  their  pernicious 
activities  in  the  direct  destruction  of  the  body  cells.* 

Many  a  pale-faced  woman  would  find  speedy  relief  from  her 
pallor,  anaemia,  and  sluggish  circulation  by  overcoming  her 
downcast  and  despondent  disposition  —  by  simply  "  cheering  up."' 

Faith  by  its  stimulating  action  upon  the  circulatory  and  elimi- 
native  processes,  greatly  lessens  the  danger  of  the  body  from  the 
results  of  the  accumulation  of  these  pernicious  body  poisons ; 
while  the  depressing  influence  of  fear  not  only  favors  their  pro- 
duction and  action,  but,  according  to  recent  experiments,  fear, 
worry,  and  anger  are  in  themselves  directly  responsible  for  the 
production  of  certain  special,  subtle  "  fear  toxins,"  which  are 
exceedingly  harmful  to  the  human  organism. 

Faith  and  fear  seem  to  be  able  to  influence  the  elaboration  of 
the  various  antitoxins  which  the  body  produces  to  neutralize  and 
combat  the  toxins  of  the  various  microbic  maladies.  Circulatory 
disturbances  and  nervous  derangements  of  psychic  origin  indi- 
rectly react  to  retard  the  formation  of  anti-bodies  and  delay  the 
production  of  these  antitoxins. 

Faith,  no  doubt,  is  a  material  aid  in  resisting  most  infectious 
diseases.  Fear  has  long  been  recognized  as  a  very  powerful 
factor  in  diseases  of  this  sort,  predisposing  its  victims  to  infec- 
tion and  to  contraction  of  the  various  contagious  and  infectious 
maladies.  Those  who  fear  a  disease  most  are  most  likely  to 
catch  it.  Those  who  fear  it  least  are  less  likely  to  contract  it. 
Fear  unfailingly  interferes  with  the  normal  working  of  those 
processes  essential  to  resisting  disease. 


See  The  Science  of  Living,  chapter  xvr. 


4o  WORRY  AND  NERVOUSNESS 

SECRETION    IN    GENERAL 

Precise  experimental  inquiry  and  careful  clinical  observations 
have  demonstrated  beyond  the  shadow  of  a  doubt  that  the  physiol- 
ogy of  secretion  throughout  the  body  is  more  or  less  influenced 
by  the  physic  state;  while  certain  special  instances,  such  as  the 
stomach  secretions,  are  almost  wholly  and  completely  under  men- 
tal control  and  nervous  direction.  The  secretion  of  the  saliva, 
the  gastric  juice,  as  well  as  that  of  the  liver,  and  even  the  kid- 
neys, is  markedly  influenced  by  the  temperamental  state  of  one's 
mind. 

Many  a  mother  engaged  in  nursing  her  infant  has  had  her 
milk  dried  up  and  has  been  compelled  to  wean  the  child  as  a 
result  of  chronic  fear  —  worry.  Fear  can  not  only  diminish  or 
stop  the  secretion  of  milk,  but  it  is  a  well  known  fact  that  anger 
and  fretting,  grief  and  despondency,  are  able  actually  to  change 
the  character  of  the  secretions  of  the  mammary  gland,  so  that 
the  milk  may  become  highly  injurious  or  positively  poisonous  to 
the  sucking  child. 

INFLUENCE   OF   THE    MIND   ON    DIGESTION 

Faith  —  expectant  hunger  —  produces  an  abundant  flow  of 
gastric  juice  from  the  secreting  glands  located  in  the  walls  of  the 
stomach ;  while  fear,  grief,  worry,  and  fretting  invariably  de- 
crease the  secretion  and  lessen  the  flow  of  the  gastric  juice. 
Chronic  worriers  and  despondent  patients  usually  suffer  from 
deficient  gastric  juice  and  slow  digestion. 

The  pleasant  emotions  all  favor  the  secretion  of  an  increased 
quantity  of  gastric  juice  by  their  salutary  influence  upon  a  man's 
appetite  and  general  good  humor ;  while  the  depressing  and  surly 
frame  of  mind  unfailingly  contributes  to  decreasing  the  amount 
of  the  stomach's  secretions. 

In  his  remarkable  experiments  upon  dogs,  Pawlow,  the  Rus- 
sian physiologist,  demonstrated  that  the  secretion  of  the  gastric 
juice  during  the  first  half  of  digestion  is  quite  entirely  regulated 
by  the  sense  of  taste  and  the  keenness  of  the  appetite.  The 
presence  of  food  in  the  stomach,  with  the  exception  of  milk  and 
certain  meat  and  vegetable  juices,  produces  no  secretion  of  gas- 
tric juice  whatever;  whereas  the  thought  of  eating  or  the  desire 


POWER  OF  THE  MIND  OVER  THE  BODY         41 

to  eat,  or  even  the  agreeable  smell  of  food,  produces  an  abundant 
flow  of  strong  gastric  juice  in  about  four  and  a  half  minutes. 
This  initial  juice —  the  only  juice  to  be  found  in  the  stomach 
during  the  first  half  of  digestion  —  has  therefore  aptly  been 
called  "  appetite  juice  "  or  "  psychic  juice." 

Recent  experiments  go  to  show  that  the  "  hunger  contractions  n 
of  the  stomach  are  quite  largely  under  mental  control.  By  the 
exercise  of  will  power,  or  by  diverting  the  mind,  it  is  possible 
greatly  to  lessen  and  otherwise  to  control  the  behavior  of  the 
empty  stomach  when  it  is  executing  these  peculiar  movements 
known  as  "  hunger  contractions."' 

Jacoby  cites  an  interesting  case  in  this  connection : 

PSYCHIC    VOMITING 

A  drastic  example  of  this  nature  (psychic  vomiting)  is  furnished 
by  the  case  of  a  man  of  middle  age,  with  no  heredity  taint  and  who 
never  had  been  sick,  who  arranged  for  a  trip  to  Europe  to  obtain  a 
much-needed  vacation,  and  who  about  a  week  before  the  time  set  for 
sailing,  was  taken  with  nausea  and  vomiting.  His  malady  increased 
from  day  to  day  and  could  not  be  controlled  by  treatment.  The 
most  careful  physical  examination  failed  to  reveal  any  cause  for 
the  trouble.  Finally,  when  no  food  of  any  kind  could  be  retained,  the 
trip  had  to  be  given  up  as  the  patient  was  too  ill  to  leave  home. 

The  distressing  state  persisted  until  the  steamer  had  left  without 
him,  and  then  all  symptoms  of  illness  disappeared  at  once.  The 
abrupt  change,  together  with  other  facts,  led  me  to  believe  the  patient 
was  suffering  from  a  species  of  psychic  seasickness.  Feeling  well, 
the  patient  scoffed  at  that  idea  of  the  mental  origin  of  his  trouble. 
The  episode  had  been  forgotten,  when,  six  years  later,  a  trip  abroad 
again  was  planned  and  cabins  secured.  A  week  before  the  time  set 
for  that  sailing,  the  same  symptoms  of  nausea  and  vomiting  recurred. 
This  time  the  tickets  were  given  up  after  two  days  of  illness,  and 
again  with  the  same  result,  cessation  of  the  symptoms.  Since  that 
time,  as  a  result  of  many  interviews  and  much  explanation  through 
which  the  patient  was  made  to  realize  the  cause  and  to  understand 
the  development  of  his  attacks,  he  has  been  abroad  without  more 
than  the  actual  mat  de  mer  which  a  stormy  voyage  entitled  him  to 
have. 

There  can  no  longer  be  any  doubt  that  many  cases  of  slow  di- 
gestion  and  sluggish   stomach   work  are   in  some   measure,   at 


42  WORRY  AND  NERVOUSNESS 

least,  due  to  the  unfortunate  mental  and  nervous  states  of  the 
sufferer.  If  the  mind  can  be  awakened  and  the  spirits  revived, 
such  patients  will  immediately  begin  to  show  improvement,  and 
many  will  pass  on  to  full  recovery. 

Fear  exercises  an  influence  of  general  depression  over  the 
entire  process  of  digestion,  including  stomach  and  bowels.  Fear 
and  fright  are  able,  temporarily,  to  paralyze  the  secretory  func- 
tions and  muscular  activities  of  both  stomach  and  intestines. 

MENTAL   INFLUENCE  ON    METABOLISM 

If  the  mind  is  indeed  able  to  influence  the  nutrition  of  the 
cell,  it  must  be  evident  that  it  is  able  to  influence  and  more  or 
less  control  the  entire  nutrition  and  metabolism  of  the  whole 
body.  One  of  the  first  steps  in  the  great  process  of  metabolism 
is  digestion ;  and  since  the  mind  is  able  most  markedly  to  control 
the  digestion,  it  becomes  very  evident  that  the  mental  factor  in 
metabolism  must  be  large  and  powerful.  Assimilation  is  the 
next  important  act  in  the  conversion  of  the  food  into  the  living 
tissues.  Fear  is  able,  temporarily,  almost  to  paralyze  the  process 
of  assimilation,  and  even  oxidation ;  while  chronic  worry  more 
or  less  permanently  deranges  the  absorptive  powers  of  the  whole 
digestive  system. 

The  appetite  controls  and  determines  the  strength  of  the  di- 
gestive juices  of  the  stomach;  the  appetite  dictates  the  quantity 
and  quality  of  the  food  eaten;  and  it  is  a  well-known  fact  that 
the  appetite  is  in  a  very  large  measure  under  psychic  control. 
Who  has  not  seen  the  invalid,  void  of  appetite,  brighten  up  and 
actually  begin  to  eat  and  relish  food  on  a  daintily  served  tray? 
On  the  other  hand,  but  in  contrast  with  this  salutary  effect  of 
faith  upon  the  appetite,  note  the  disastrous  effect  upon  the 
patient's  appetite  when  the  food  is  improperly  prepared  or  un- 
acceptably  served. 

EFFECT  OF  THE  MIND  ON  THE  MUSCULAR  SYSTEM 

Faith  unfailingly  increases  the  energy  and  endurance  of  the 
muscles.  The  courageous  man  can  actually  perform  more  work 
in  a  given  time  than  can  he  whose  mind  is  filled  with  doubts  and 
despondency.     Fear  decreases  the  power  of  the  muscular  system 


POWER  OF  THE  MIND  OVER  THE  BODY         43 

to  perform  physical  work;  it  diminishes  muscular  energy  and 
lessens  muscular  endurance.  Even  mental  work  detracts  from 
muscular  power.     (Fig.  2,  d.) 

The  effect  of  mind  on  muscle  is  nowhere  better  shown  than  in 
the  bodily  carriage.  The  man  of  faith  walks  with  a  bold  carriage 
and  a  confident  step.  The  gait  is  elastic;  the  physical  poise  is 
energized ;  and  the  bodily  movement  indicates  courage  and  self- 
confidence.  This  is  the  picture  presented  by  a  healthy  person 
walking  along  the  street,  whose  mind  is  in  a  natural  and  normal 
state  —  filled  with  faith  and  hope.  In  contrast  with  such  a  mov- 
ing picture  of  muscular  force  and  energy,  let  the  reader  recall 
the  figure  of  some  discouraged  and  disheartened  man  walking 
down  the  avenue.  The  carriage  is  weak  and  slovenly,  the  gait 
shuffling,  and  the  step  inelastic;  the  body  is  being  fairly  dragged 
along,  every  muscle  weak  and  relaxed.  The  stamp  of  mental  de- 
feat has  been  transferred  to  the  material  body.  The  physical 
man  reflects  the  picture  of  mental  weakness,  doubt,  and  defeat. 

Fear,  like  certain  poisonous  toxins,  is  able  to  produce  spas- 
modic contractions  of  the  muscles;  especially  is  the  fear  state  of 
mind  able  to  provoke  spasm  of  the  involuntary  muscles  of  the 
blood  vessels  and  the  digestive  system.  These  abnormal  tend- 
encies to  involuntary  muscular  contraction  are  directly  respons- 
ible for  numerous  cases  of  pale  skins,  cold  feet,  and  other 
disagreeable  functional  disturbances. 

All  forms  of  fear  and  unhealthy  emotion  have  a  great  in- 
fluence on  the  muscles,  especially  of  the  face  and  hands.  Ex- 
pression, indeed,  depends  on  contractions  and  relaxations  of 
the  facial  muscles.  Cheerfulness  favorably  excites  all  the  mus- 
cular system,  and  in  its  higher  manifestations  provokes  laughter, 
dancing,  jumping,  and  leaping;  when  more  moderate,  it  causes 
the  mouth  and  the  eyes  to  become  highly  expressive  of  pleasure, 
the  upper  lip  is  elevated  and  the  teeth  are  displayed.  Joy 
brightens  the  eyes,  expands  the  nostrils,  raises  the  angles  of  the 
mouth,  elevates  the  eyebrows,  and  energizes  the  vocal  muscles, 
imparting  a  peculiar  and  characteristic  expression  to  the  voice  — 
in  fact,  inspires  the  whole  body  to  an  expression  of  happiness 
and  satisfaction. 

The  power  of  suggestion  to  influence  the  muscles  is  indicated 


44  WORRY  AND  NERVOUSNESS 

by  the  following  clipping  relative  to  a  death  from  pseudo-hydro- 
phobia. 

DIES   FROM    HYDROPHOBIA    ALTHOUGH    NOT    WOUNDED 

Strain  of  Nursing  Husband,  Who  Was  Bitten  by  Dog,  Causes  Fatal 
Illness  of  Milwaukee  Woman 

Milwaukee,  Wis.,  Dec.  I. —  After  suffering  for  weeks  from  shock 
caused  by  her  experience  of  nursing  her  husband  until  he  died  from 
hydrophobia,  Mrs.  X —  of  Kenosha,  28  years  old,  died  in  a  Milwaukee 
hospital  today. 

A  year  ago  her  husband  was  bitten  by  a  pet  dog,  and  a  few  months 
later  developed  rabies.  He  grew  steadily  worse  and  the  wife  in- 
sisted on  remaining  at  his  bedside  when  even  the  physician  was 
afraid  of  his  savage  attacks. 

When  he  died  she  left  the  bedside  a  nervous  wreck,  and  soon  after 
developed  symptoms  similar  to  those  of  her  husband's  malady.  Al- 
though it  is  claimed  she  was  under  a  delusion,  she  imagined  that  her 
husband  had  bitten  her,  and  she  died  in  the  agonies  which  this  would 
bring  about. 

EFFECTS   OX   SKIN    AND   HEAT   REGULATION 

The  skin  is  one  of  the  most  important  eliminative  organs  of 
the  body.  The  psychic  state,  by  its  influence  through  the  nerves 
and  upon  the  circulation,  is  able  very  markedly  to  interfere  with 
the  normal  process  of  elimination  through  the  glands  of  the  skin. 
Faith  undoubtedly  assists  in  skin  elimination,  while  fear  un- 
questionably hinders  and  hampers  the  process. 

Thousands  of  pale-skinned  and  anaemic  persons  suffering  from 
indigestion,  headache,  and  habitually  cold  hands  and  feet,  would 
be  wonderfully  and  immediately  helped  if  they  could  but  discover 
the  secret  of  happiness  and  the  source  of  mental  peace  if  they 
would  only  "  cheer  up." 

Hirsch  cites  a  drastic  example  illustrating  the  mental  influence 
on  heat  regulation,  mentioned  by  his  former  teacher,  the  physiolo- 
gist Preyer,  as  proof  of  the  possibility  of  an  intentional  auto- 
suggestion. Preyer  recounted  that  he  never  allowed  his  study 
to  be  heated,  but  utilized  his  will  power  —  that  is,  his  capability 
of  auto-suggestion  —  to  eliminate  the  sensation  of  cold.  By 
means  of  the   auto-suggested  sensation   of  warmth,  it  became 


POWER  OF  THE  MIND  OVER  THE  BODY         45 

possible  for  him  to  work  in  comfort  in  a  cold  room  and  to  bathe 
in  ice-cold  water. 

The  sensations  of  heat  and  cold  are  entirely  based  on  the  re- 
ports furnished  by  the  temperature  nerves  resident  in  the  skin. 
When  faith  dominates  the  mind,  the  temperature  sense  of  the 
skin  carries  on  its  work  after  the  natural,  normal  fashion.  Fear 
never  fails  to  derange  this  important  part  of  the  heat-regulating 
mechanism.  Fear  and  fright  are  able  to  produce  actual  goose- 
flesh  appearance  of  the  skin.  Mental  disturbances  have  been 
shown  to  be  able  wholly  or  partially  to  abolish  the  sensations 
of  heat  and  cold.  The  appearance  of  goose-flesh  from  psychic 
stimuli  constitutes  ample  proof  of  the  direct  power  of  the  mind 
over  involuntary  or  unstriped  muscle. 

RESPIRATION    AND    THE    MENTAL    STATE 

Faith  and  courage  induce  deep  breathing.  The  respiration  of 
the  optimist  is  usually  regular,  slow,  and  deep.  The  victims  of 
fear  and  fright  are  nearly  always  shallow  breathers,  the  respira- 
tory action  being  quick  and  irregular.  Nearly  all  sufferers  from 
the  "  blues  "  are  observed  to  be  superficial  breathers,  while  the 
man  who  has  a  pleasant  and  hopeful  disposition  is  almost  invar- 
iably found  to  be  a  deep  breather. 

Good  cheer  and  optimism  help  in  the  development  of  the  chest. 
Men  of  courage  and  women  of  faith,  as  a  rule,  possess  strong, 
robust,  and  well  developed  chests.  Their  lung  capacity  is  usually 
above  the  average.  The  unfortunate  and  melancholic  victims  of 
fear,  grief,  and  worry  almost  invariably  suffer  from  a  depression 
of  the  chest  as  well  as  depression  of  spirits. 

Faith  and  fear  indirectly  influence  both  the  strength  and  capac- 
ity of  the  lungs,  by  their  power  to  modify  the  depth  of  breathing, 
and  consequently  to  control  the  development  of  the  chest.  The 
cringing  and  fearful  devotees  of  grief  and  worry  unfailingly 
exhibit  an  unnatural  and  abnormal  mode  of  breathing.  These 
fearful  ones  are  prone  to  employ  chest  or  thoracic  breathing  to 
the  neglect  or  exclusion  of  the  abdominal  or  diaphragmatic  ele- 
ment of  natural  respiration.  Even  mental  application  markedly 
affects  the  breathing.     (Fig.  3,  e  and  f.) 

It  is  a  well-known  fact  that  the  mind  can  immediately  and 


46  WORRY  AND  NERVOUSNESS 

strongly  influence  those  modified  and  special  respiratory  mani- 
festations known  as  coughing  and  sneezing.  A  very  large  per- 
centage of  common,  chronic,  hawking  coughs  are  largely 
perpetuated  by  the  mental  state,  coupled  with  the  force  of 
habit.  Fear-attention  is  certainly  able  to  generate  and  maintain 
a   formidable  cough. 

The  mental  state  is  equal  to  or  greater  than  fatigue  in  its 
power  to  produce  yawning.  The  tendency  to  yawn  is  greatly 
increased  by  suggestion ;  but  hiccupping  is  not  so  easily  produced 
or  cured  by  suggestion.  It  is  a  common  experiment  for  one  to 
yawn  repeatedly  and  audibly,  especially  during  the  course  of  the 
evening  when  in  the  presence  of  a  small  company  of  people,  and 
in  five  minutes  from  one-half  to  three-fourths  of  the  entire  num- 
ber will  have  begun  to  yawn. 

An  interesting  case,  reported  by  Moll,  is  that  of  an  opera  singer 
without  organic  heart  or  lung  disease,  who  maintained  that 
whenever  she  was  in  a  closed  room  she  suffered  from  shortness 
of  breath  and  an  attack  of  suffocation,  which  disappeared  at 
once  when  a  window  was  opened  and  fresh  air  came  into  the 
room.  Medical  treatment  had  failed  to  relieve  her  of  this  evi- 
dently functional  trouble.  One  evening  after  a  performance 
she  came  home  ill  and  went  to  bed  at  once.  After  a  few  hours 
she  awoke  with  all  manifestations  of  severe  respiratory  oppres- 
sion. The  only  means  of  relief,  she  thought,  would  be  the  open- 
ing of  a  window,  but  she  felt  too  weak  to  get  up.  In  her  fear 
the  oppression  would  increase,  she  took  up  a  candlestick  standing 
near  her  bedside  and  threw  it,  as  she  believed,  at  the  window. 
The  noise  of  broken  glass  falling  to  the  floor  indicated  the  ac- 
complishment of  her  purpose.  At  once  she  felt  very  much  re- 
lieved by  the  "  inflow  "  of  fresh  air  and  quickly  went  to  sleep. 
The  next  morning  awaking  well  and  refreshed,  she  saw  to  her 
great  surprise  that  it  was  not  the  window  which  had  been  broken, 
but  a  looking  glass  hanging  beside  it ;  that,  therefore,  there  had 
been  no  inrush  of  fresh  air,  and  that  the  relief  from  her  oppres- 
sion, as  well  as  its  origin,  had  been  due  entirely  to  her  imagina- 
tion. From  that  time  she  really  was  cured  and  these  attacks  of 
oppression  no  longer  occurred. 

The  mind  is  able  greatly  to  influence  both  asthma  and  hay- 


POWER  OF  THE  MIND  OVER  THE  BODY         47 

fever,  yet  it  should  not  for  one  moment  be  supposed  that  these 
diseases  are  purely  mind  disorders ;  they  usually  represent  a  real 
physical  disturbance  or  nervous  derangement,  nevertheless, 
numerous  cases  are  on  record  where  both  of  them  have  been 
entirely  cured  or  greatly  relieved  by  suggestion.  On  the  other 
hand,  numerous  attacks  of  asthma  and  hay-fever  have  undoubt- 
edly been  precipitated  by  false  fears. 

INFLUENCE  OF  THE  EMOTIONS  ON  BRAIN  AND  NERVOUS  SYSTEM 

Faith  promotes  those  physical  conditions  of  the  brain  which 
lend  themselves  to  clear  and  decisive  mental  action,  while  fear 
reacts  on  both  brain  and  mind,  to  the  disorder  of  one  and  the 
confusion  of  the  other.  Worry  invariably  beclouds  the  mental 
activities  and  renders  the  brain  action  more  or  less  sluggish. 
The  mental  activities  of  the  modern  civilized  races  have  become 
increasingly  intense.  Today  men  and  women  whose  brains  act 
promptly  and  decisively  are  at  a  premium.  The  care-free  and 
the  joyous  are  able  to  do  a  vast  amount  of  taxing  brain  work, 
experiencing  but  little  mental  fatigue ;  whereas  the  victims  of 
grief  and  worry  find  themselves  on  the  verge  of  brain  fag  after 
engaging  in  the  most  ordinary  mental  activities.  Even  such  a 
serious  nervous  disorder  as  paralysis  agitans  is  thought  to  be 
caused  largely  by  chronic  worry. 

The  emotions  produce  literal  changes  in  the  brain.  Crile,  in 
reporting  his  experiments  and  observations  in  this  matter  says: 

A  long  series  of  laboratory  experiments  on  animals  subjected,  some 
to  emotional  excitation,  and  others  to  physical  trauma  under  anes- 
thesia, showed  that  identical  brain-cell  changes  were  caused  in  each 
case.  That  is,  both  physical  and  psychic  stimulation  exhaust  the 
physical  substance  of  the  brain  cells.  Emotional  stimulation  not  only 
cause  brain-cell  deteriorations,  but  produce  also  an  increase  of  the 
internal  activating  secretions  —  epinephrin,  thyroid  secretion,  glyco- 
gen—  a  vital  point  in  cases  of  hypertension. 

In  every  way  faith  permits  and  favors  sound  and  refreshing 
sleep,  while  fear  and  worry  are  responsible  for  that  type  of  un- 
natural and  disturbed  rest  which  is  almost  invariably  associated 
with  mental  depression.     Grief  and  anxiety  are  able  so  greatly 


48  WORRY  AND  NERVOUSNESS 

to  disturb  the  circulation  and  other  physical  conditions  in  the 
brain  as  temporarily  to  drive  away  the  ability  to  sleep. 

The  action  of  the  nerve  centers  is  dependent  on  the  quantity 
and  quality  of  the  energy  granules  which  are  found  in  the  cell 
bodies  of  the  neurons.  Fear  undoubtedly  possesses  the  power  of 
prematurely  discharging  and  extravagantly  using  up  the  energy 
reposed  in  these  so-called  energy  granules.  It  has  been  con- 
clusively shown  that  the  victims  of  fear  are  invariably  visited 
with  premature  nervous  exhaustion  and  untimely  mental  fatigue. 

FEAR   IX    RELATION   TO   NEURASTHENIA 

Faith  increases  the  power  of  the  mind  to  control  the  nervous 
system  evenly  and  continuously.  Self-possession  steadies  the 
nerves.  Fear  weakens  the  mind's  control  of  the  nervous  sys- 
tem, unsteadies  the  nerves  and  in  some  cases  produces  actual 
tremors.  Many  cases  of  so-called  neurasthenia  are  entirely  due 
to  an  unsettled  and  abnormal  state  of  the  intellect.  If  such 
patients  could  only  focus  their  minds  on  something  outside  of 
themselves  and  busy  their  hands  with  some  useful  and  agree- 
able work,  they  would  almost  immediately  find  themselves  re- 
lieved of  their  distressing  nervous  affliction. 

Sincere  faith  and  optimistic  trustfulness  appear  actually  to 
strengthen  the  nerves.  The  mind  probably  exerts  this  favorable 
influence  over  the  nerve  centers  by  conserving  the  nervous  energy 
and  economizing  the  expenditure  of  the  energy  granules  found 
in  the  neuron,  as  well  as  by  lessening  useless  nerve  impulses 
and  decreasing  unnecessary  muscular  movements.  On  the  other 
hand,  fear  decreases  the  nervous  strength.  Anxiety  and  worry 
are  among  the  leading  causes  of  neurasthenia. 

Faith  facilitates  nervous  recuperation  and  in  a  general  way 
increases  the  nutrition  of  the  nerves  and  nerve  centers.  When 
the  mind  is  peaceful  the  nerve  units  are  able  to  carry  on  their 
work  with  an  expenditure  of  a  minimum  amount  of  energy. 
Fear  is  responsible  for  useless  and  wasteful  nervous  action;  it 
squanders  the  nerve  energy.  Worry  produces  a  sort  of  nerve 
starvation  in  consequence  of  the  premature  and  extravagant 
expenditure  of  the  energy  granules  contained  in  the  body  of  the 
nerve  cell. 


POWER  OF  THE  MIND  OVER  THE  BODY  49 

Faith  energizes  and  invigorates  the  nervous  functions.  Fear 
diminishes,  retards,  even  paralyzes  the  nervous  activities.  Faith 
and  determination  have  cured  many  a  case  of  supposed  genuine 
paralysis.  Thousands  of  people  are  suffering  from  pseudo- 
paralysis ;  they  were  paralyzed  at  one  time,  but  have  gotten  well 
and  never  discovered  the  fact. 

MENTAL    INFLUENCE    OVER   THE    SPECIAL    SENSES 

Faith  and  courage,  confidence  and  calmness,  never  fail  to  in- 
crease one's  hunger  and  sharpen  the  appetite.  Good  cheer  creates 
a  demand  for  food  as  well  as  satisfaction  in  partaking  of  the 
same.  Fear,  together  with  other  morbid  and  sordid  mental 
states,  lessens  the  appetite,  blunts  the  taste,  depresses  hunger,  and 
sometimes  completely  abolishes  the  desire  for  food.  (Note  how 
taste  influences  the  pulse  as  shown  in  Fig.  3,  a  and  b.) 

A  pleasant  frame  of  mind  undoubtedly  enhances  the  sense  of 
smell,  while  fear  may  so  paralyze  this  special  sense  as  greatly  to 
decrease  or  entirely  prevent  one's  ability  to  detect  common  odors. 
Xot  only  does  fear  possess  the  power  of  crippling  or  inhibiting 
the  sense  of  smell,  but  it  is  also  actually  able  to  create  false 
odors ;  that  is,  to  cause  one  to  smell  fictitious  and  imaginary  odors. 

Self-confidence  and  moral  peace  never  fail  to  render  the  hear- 
ing more  acute.  In  fact,  faith  has  cured  many  a  case  of  hysteric 
deafness.  It  is  a  well-known  fact  that  nervous  people,  whose 
minds  are  constantly  in  a  state  of  agitation,  are  not  able  to  ap- 
preciate good  music  as  are  those  with  a  quiet  and  composed  men- 
tal state. 

Fear  is  also  able  to  produce  the  well-known  condition  of  hys- 
teric blindness,  while  faith  and  determination  are  able  to  cure 
and  entirely  remove  this  troublesome  ailment.  Fear  and  its  allied 
states  are  sometimes  able  to  lead  up  to  that  point  where  delusions 
are  developed.  The  sufferer  sees  things  which  have  no  real  ex- 
istence. He  imagines  strange  people  are  dogging  his  steps, 
imaginary  enemies  constantly  on  his  trail,  and  even  thinks  people 
on  the  street  are  making  faces  at  him. 

THE    CONCLUSION    OF    THE    WHOLE    MATTER 

We  have  now  carefully  traced  the  influence  of  faith  and  fear 
upon  the  heart,  the  blood  vessels,  circulation,  respiration,  secre- 


50  WORRY  AND  NERVOUSNESS 

tions,  digestion,  muscles,  skin,  nervous  system,  brain,  and  the 
special  senses.  The  entire  matter  can  be  briefly  summarized  as 
follows : 

1.  All  faith  tendencies  are  toward  mental  happiness  and  phys- 
ical health.  All  people,  good  or  bad,  get  the  physical  rewards  of 
faith,  regardless  of  whether  the  objects  of  their  faith  and  belief 
arc  true  or  false.  Faith  reacts  favorably  upon  the  body  inde- 
pendent of  the  fineness  of  the  object  or  the  correctness  of  the 
thing  believed.  Faith  is  the  natural,  normal,  and  healthy  state  of 
mind  for  man.  Faith  is  the  state  of  mind  that  ever  tends  to 
make  a  man  better,  stronger,  happier,  and  healthier. 

2.  Fear  and  all  its  tendencies  arc  toz^ard  mental  despair  and 
physical  disease.  All  people,  good  or  bad,  reap  the  physical  re- 
wards of  fear  even  though  its  basis  may  be  entirely  false.  There 
is  a  reaction  of  despair  and  disease  following  all  fear,  doubt,  and 
-worry.  The  thing  feared  may  be  a  hobgoblin  or  a  phantom,  but 
the  effects  of  fear  upon  the  body  are,  nevertheless,  unfailingly  de- 
teriorating and  disease-producing.  Fear  and  worry  are  incom- 
patible with  mental  peace  and  physical  Jiealth.  Deliverance  from 
the  thraldom  of  fear  is  essential  to  the  mental,  moral,  and  phys- 
ical emancipation  of  the  human  race. 


CHAPTER  V 
CHRONIC  FEAR  OR  COMMON  WORRY 

IN  EVERY  age,  the  human  race  has  suffered  tremendously 
from  the  disastrous  consequences  of  chronic  fear  or  common 
worry,  but  it  has  fallen  to  the  lot  of  our  present-day  civilization, 
with  its  intensity  and  complexity,  to  suffer  in  an  unusual  degree 
from  the  direful  consequences  of  mental  strain,  social  anxiety, 
and  commencial  stress. 

WHAT    IS    WORRY? 

It  is  exceedingly  difficult  to  frame  an  acceptable  definition  for 
worry.  A  patient  once  described  her  mental  state  to  me  by  say- 
ing that  her  "  mind  just  took  tight  hold  of  an  idea,  and  simply 
would  not  let  go."  It  would  seem  that  worry  might  truthfully  be 
called  a  "  spasm  of  the  attention,"  a  sort  of  continued  fit  of  men- 
tal concentration.)  Worry  is  a  diseased  self-consciousness  —  an 
undue  and  exaggerated  solicitude  on  any  subject.  Concentration 
of  the  mental  energies  is  highly  essential  to  the  performance  of 
first-class  brain  work,  and  so  it  would  seem  that  the  danger  of 
worry  is  ever  associated  with  a  high  degree  of  mental  concen- 
tration. 

£  It  is  very  necessary  that  the  mind  should  take  fast  hold  upon 
an  idea  or  a  group  of  ideas  in  order  to  perform  efficient  mental 
work ;  on  the  other  hand,  if  this  intellectual  concentration  is  too 
long  continued;  if  the  mind  fails  to  release  its  grasp;  if  the 
psychic  focus  becomes  continuous,  then  we  have  reached  the 
borderland  of  anxiety,  the  realms  of  fear  —  actual  worry.  Wor- 
ry is  a  simple  functional  disorder  of  the  mind  —  a  chronic  proc- 
ess of  "  making  mountains  out  of  mole  hills.' j 

FORETHOUGHT   VERSUS   FEARTHOUGHT 

And  so  we  find  that  worry  turns  out  to  be  a  sort  of  a  "  one- 
sided mental  action."    Worry  may  be  defined  as  "  fearthought " 

5i 


52  WORRY  AXD  NERVOUSNESS 

in  contradistinction  to  "  forethought."  Forethought  is  highly 
necessary  to  the  smooth  running  of  our  daily  affairs,  while  fear- 
thought  is  wholly  unnecessary  and  even  highly  injurious.  Worry 
is  nothing  more  or  less  than  "  chronic  fear."  It  is  a  well  known 
fact  that  any  single  fear  or  group  of  fears,  when  long  entertained 
in  the  mind,  tend  to  crystallize  themselves  into  definite  worry, 
which  immediately  begins  its  corroding  process  of  incessantly 
harassing  the  mind,  torturing  the  soul,  while  it  so  effectively  dis- 
sipates the  mental  energies  and  weakens  the  nervous  forces. 
Worry  is  nothing  more  nor  less  than  a  sort  of  mental  indigestion 
—  psychic  dyspepsia. 

Forethought  is  a  wise  general  of  the  intellectual  forces,  mak- 
ing an  intelligent  comparison  between  the  experiences  of  the 
past  and  the  present  while  discriminatingly  planning  for  the 
future.  Forethought  is  never  unmindful  of  our  present  difficul- 
ties, neither  is  it  blind  to  those  which  may  be  encountered  in  the 
future.  Fearthought  is  nothing  more  or  less  than  a  process  of 
borrowing  trouble  from  the  future  for  the  purpose  of  augment- 
ing our  present  sorrows.  Edward  Everett  Hale  once  said: 
"  Some  people  have  three  kinds  of  trouble  —  all  they  ever  had, 
all  they  now  have,  and  all  they  ever  expect  to  have."  Worry, 
while  ever  posing  as  solicitous  for  our  welfare,  is  a  false  friend, 
a  dangerous  traitor  to  the  natural  laws  governing  the  realm  of 
mind  and  morals. 

THE    PSYCHOLOGY    OF    WORRY 

Man  is  truly  the  only  animal  that  makes  himself  ridiculous  by 
worry.  The  biologists  teach  us  that  intelligence  (the  liability  to 
worry)  exists  only  in  those  animals  high  enough  up  in  the 
biological  scale  to  possess  associative  memories.  Man  pos- 
sesses a  high  degree  of  memory  association.  As  Shakespeare  has 
said,  man  is  made  "  with  such  a  large  discourse,  looking  before 
and  after."  Numerous  experiments  made  upon  lower  animals 
serve  to  prove  that  much  of  their  apparently  intelligent  action  is 
purely  instinctive  —  hereditary.  They  do  not  reason  intelligently. 
The  lower  forms  of  life  seem  utterly  unable  to  profit  by  exper- 
ience—  they  have  little  or  no  associative  memory,  and,  of  course, 
they  are  not  addicted  to  the  human  vice  of  worry.    In  ascending 


CHRONIC  FEAR  OR  COMMON  WORRY  53 

the  scale  of  animal  life,  interesting  problems  are  encountered 
when  we  reach  the  ant  tribes ;  and  it  seems  highly  probable  that 
wasps  do  actually  possess  certain  powers  of  associative  memory. 

Man,  in  short,  suffers  quite  differently  from  the  animals  and  he 
suffers  more  than  they.  He  does  not  content  himself,  so  to 
speak,  with  brute  suffering  which  is  adequate  for  the  physical 
disorders;  he  increases  them  by  imagination,  aggravates  them 
by  fear,  keeps  them  up  by  his  pessimistic  reflections. 

And  so  the  higher  we  ascend  in  the  scale  of  animal  life,  the 
greater  the  tendency  to  worry  —  to  look  with  fear  and  misgiv- 
ing upon  that  which  the  future  holds  in  store,  or  to  be  unduly  ap- 
prehensive concerning  the  difficulties  and  problems  of  the  pres- 
ent. Worry  is  simply  some  sort  of  abnormally  insistent  thought 
—  some  idea  you  can't  get  away  from  —  a  notion  that  grips  you 
with  a  power  you  are  unable  to  break.  It  should  be  remembered 
that  while  our  imaginary  worries  are  unreal,  nevertheless,  a  wor- 
ried imagination  is  one  of  the  most  real  things  in  the  world,    j 

THE    GENERAL   CAUSES   OF   WORRY 

The  uncertainties  and  vicissitudes  of  life  upon  our  planet  are 
such  as  to  render  more  or  less  worry  inevitable.  A  certain  de- 
gree of  mild  worry,  a  certain  amount  of  anxiety,  it  would  seem, 
is  ever  attached  to  the  living  state.  (jLife  is  the  one  great  source 
of  worry.  Death  alone  affords  perfect  and  permanent  relief  from 
from  the  liability  of  fear  and  the  tendency  to  worry. 

The  fact  that  man  is  the  only  animal  that  worries  is  but  a 
demonstration  of  the  superiority  of  the  human  mind  over  that 
of  the  lower  animals.  Animals  are  not  given  to  looking  back- 
ward, and,  as  a  rule,  they  do  not  look  very  far  into  the  future ; 
on  the  other  hand,  the  mind  of  man  sweeps  back  over  past  ages, 
and,  from  the  page  of  history,  as  well  as  from  the  perplexing 
incidents  of  the  present,  forms  those  conclusions  which  cause 
him  to  look  with  fear  and  trembling  into  the  future. 

The  causes  of  human  worry  are  indeed  varied,  but  in  the  last 
analysis  they  are  usually  found  to  consist  in  some  form  of  nerve 
irritation,  mental  anxiety,  or  moral  fear.  It  not  infrequently  de- 
velops that  numerous  habits  of  life  as  well  as  certain  physical 
practices  are  contributory  to  the  development  of  the  worry  habit. 


54  WORRY  AND  NERVOUSNESS 

The  use  of  alcohol,  and  many  other  forms  of  both  psychic  and 
physical  transgression,  are  often  discovered  to  be  the  hand 
maidens  of  worry  and  ancestors  of  sorrow. 

Lack  of  self-control  is  another  great  cause  of  worry.  A  strong 
will  would  cure  nine-tenths  of  this  unnecessary  and  hurtful  grief. 
Even  the  proverbial  "  wet  hen  "  could  undoubtedly  overcome  her 
anger  if  she  would  but  become  reconciled  to  the  presence  of  a 
little  moisture  or  else  become  a  trifle  indifferent  to  the  matter 
of  always  keeping  dry.  We  stand  other  people's  troubles  wry 
wTell,  and,  by  vigorously  making  up  our  minds,  we  ought  to  be 
able  to  learn  how  to  stand  our  own  without  making  so  much 
fuss  about  it.  J 

THE    EVER    PRESENT    HAPPINESS    HUNGER 

Whatever  the  immediate  cause  of  worry,  a  solicitude  for  our 
own  general  welfare,  material  prosperity,  and  mental  happi- 
ness, or  that  of  our  loved  ones,  must  be  recognized  as  the  real 
cause  of  all  our  worries.  We  worry  lest  we  may  lose  or  fail  to 
obtain  those  material  blessings  which  will  make  us  and  our 
friends  happy. 

The  desire  for  happiness,  then,  is  found  to  be  the  real,  funda- 
mental cause  of  worry;  but  it  should  ever  be  borne  in  mind  that 
under  no  circumstances  can  worry  ever  contribute  to  our  happi- 
ness ;  on  the  other  hand,  it  should  be  remembered  that  worry  and 
anxiety  never  fail  directly  to  detract  from  the  enjoyment  of 
life  —  to  destroy  our  mental  peace,  and  not  infrequently  they 
store  up  for  the  future  that  which  will  everlastingly  destroy  the 
very  happiness  for  the  love  of  which  we  are  wont  to  worry. 

Concerning  happiness  hunger  —  human  desire  —  Dubois  says: 

But  however  complicated  music  may  be,  it  nevertheless  reduce? 
itself  to  the  combination  of  seven  notes  and  their  octaves.  For  the 
sentiments,  in  spite  of  their  number  and  complexity,  the  simplifica- 
tion is  still  easier.  There  are  not  seven  sentiments,  the  combination 
of  which  would  constitute  the  sentimental  life;  there  are  two  only  — 
desire  and  fear.  The  former  urges  man  forward  and  incites  him  to 
seek  that  which  he  desires ;  the  latter  holds  him  back  and  makes  him 
recoil  from  that  which  he  fears.  In  short,  these  are  sentiments  only 
of  pleasure  and  of  displeasure.    I  go  further,  and  say  that  man  has 


CHROXIC  FEAR  OR  COM M ON  WORRY  55 

never  had  but  a  single  motive  of  action  —  desire,  whether  it  be  a 
positive  desire  that  something  happen,  or  a  negative  desire  that  some- 
thing do  not  happen.  Examine  from  this  point  of  view  all  your 
actions  and  those  of  your  fellow  men  and  you  will  always  find  this 
single  spring  setting  in  motion  all  your  energies  —  desire. 

Many  good  people  entertain  the  false  notion  that  possession  of 
material  riches  can  bestow  happiness  upon  the  soul.  They  are 
fully  possessed  of  the  idea  that  riches  are  essential  to  the  joy 
of  living.  Accordingly,  they  toil  in  anxiety  and  endure  hard- 
ships and  experience  much  mental  torture,  in  their  efforts  to 
provide  themselves  with  these  supposed  essentials  to  life  and 
happiness.  But  all  this  is  a  mistake.  True  happiness  is  rather 
derived  from  the  blessings  of  sound,  physical  health,  mental 
peace,  and  spiritual  satisfaction. 


TEMPERAMENTAL    PECULIARITIES 


v 


Some  good  people  constantly  worry  because  they  are  "  criti- 
cised "  either  justly  or  unjustly.  Some  folks  are  veritable 
human  sensitive  plants*:  they  are  always  being  "  neglected  "  or 
u  slighted,"  even  by  their  very  best  friends.  Other  good  people 
are  depressed  and  dejected  because  they  are  sure  that  their  great 
worth  is  not  fully  appreciated  by  their  associates  or  employers. 
Still  others  fret  and  fume  and  worry  because  they  feel  it  is 
their  duty  to  resent  some  supposed  or  real  injury  or  injustice 
which  has  been  done  to  them. 

This  temperamental  sort  of  worry  frequently  gives  rise  to 
violent  outbursts  of  temper  and  extraordinary  manifestations 
of  anger,  all  of  which  are  exceedingly  injurious  to  the  health  of 
the  nervous,  digestive,  and  circulatory  systems :  while  they  are 
highly  destructive  to  every  form  of  mental  happiness  and  spirit- 
ual peace. 

Other  people  worry  because  they  are  inordinately  timid  — 
bashful  or  backward.  Many  earnest  souls  constantly  fear  imag- 
inary difficulties,  fear  they  will  make  some  awful  blunder,  or 
that  they  will  utterly  fail  to  "  make  good  "  with  the  task  they 
have  in  hand.  Some  persons  always  feel  that  after  they  have 
done  their  best  thev  will   still  be  unable  to  meet  the  demands 


56  WORRY  AND  NERVOUSNESS 

which  their  position  makes  upon  them.  This  abnormal  timidity 
necessarily  results  in  producing  an  unnatural  state  of  discourage- 
ment, brooding,  and  even  despondency. 

Still  others  worry  over  their  great  responsibilities;  and,  as  a 
rule,  these  over-anxious  individuals  are  found  to  be  altogether 
too  much  concerned  about  certain  minute  details  and  other 
trifling  matters  for  which  they  are  not  at  all  personally  re- 
sponsible, and  over  which  they  exercise  little  or  no  control. 
And  yet  they  constantly  fret  and  worry  over  these  things  to 
the  point  where  they  lose  both  appetite  and  sleep. 

USELESS    WEATHER    WORRY 

Every  time  you  meet  some  folks  you  find  that  they  are  wor- 
rying over  the  weather;  they  are  not  satisfied  with  what  nature 
provides;  the  sun  shines  too  much,  or  else  it  rains  too  much. 
They  are  something  like  the  grumbling  farmer  whose  fault- 
finding and  complaining  were  proverbial  for  miles  around.  In 
the  midst  of  one  ideal  summer  (so  far  as  weather  conditions 
and  crops  were  concerned)  a  delegation  of  neighbors  called  on 
him  one  afternoon  and  expressed  the  thought  that  he  must  for 
once  be  satisfied  with  the  fine  weather  and  the  excellent  crops. 
The  old  farmer  knitted  his  brow,  scratched  his  head  for  a  mo- 
ment and  then  replied :  "  Yes,  neighbors,  the  crops  are  good 
and  the  weather  is  fine,  but  I  want  to  tell  you  that  such  crops 
are  mighty  hard  on  the  land." 

Some  men  and  women  are  literally  human  barometers.  As 
the  result  of  their  rheumatic  tendencies  coupled  with  constant 
thought  of  the  weather,  they  are  able  to  detect  a  storm  long  be- 
fore the  weather  bureau  is  aware  that  it  has  appeared  on  the 
far  distant  horizon.  Such  unfortunates  are  able  to  keep  them- 
selves on  the  border  of  nervous  prostration  by  their  constant 
worry  over  the  weather  and  from  fear  that  all  their  plans  will 
be  upset  by  rain,  storm,  or  drouth. 

Another  class  of  mental  sufferers  might  be  classified  as 
"  science  worriers."  They  are  more  or  less  bothered  over  the 
great  problems  of  the  universe.  Some  are  afraid  the  sun  will 
sometime  burn  out,  and  that  our  old  world  will  gradually  freeze 
up.    Others  live  in  constant  fear  lest  our  planet  will  collide  with 


CHROXIC  FEAR  OR  COMMON  WORRY  57 

some  stray  comet.  Several  frightened  people  committed  suicide 
during  the  recent  visit  of  Halley's  comet  to  the  neighborhood  of 
our  world.  Still  others  are  possessed  with  the  constant  fear  of 
being  struck  by  lightning;  they  are  always  terrorstricken  by 
loud  thunder. 

THE    MAGNIFICATION    OF    TRIFLES 

It  is  something  terrible  the  way  intelligent  human  beings  will 
make  a  mountain  out  of  a  molehill,  how  they  persist  in  magnify- 
ing trifles  beyond  all  measure  and  reason.  A  discouraged  and 
downcast  fellow,  struggling  with  obstacles  and  fighting  with 
failures,  will  often  deliberately  attribute  all  his  misfortune  and 
difficulties  to  some  trifling  mistake  in  his  youth,  or  to  some  in- 
significant blunder  or  minor  transgression  of  later  life. 

There  recently  came  to  our  clinic  a  young  man  whose  life  was 
a  perfect  failure;  he  had  contemplated  suicide,  but  a  friend 
urged  him  to  come  and  see  us.  This  patient  had  made  a  certain 
mistake  in  his  youth,  which  he  later  greatly  magnified  and  so  led 
himself  to  believe  that  he  could  not  succeed  in  life,  that  he  was 
doomed  to  certain  failure.  For  seven  years  he  had  lived  in  this 
slough  of  despond,  and  now  he  seriously  thought  of  taking  his 
life.  He  had  been  looking  through  the  spy  glass  of  life  at  the 
wrong  end,  and  it  was  only  necessary  to  reverse  his  telescope,  as 
it  were,  to  give  him  an  entirely  new  viewpoint  of  life.  After 
an  hour's  talk  he  was  ready  to  go  to  work  and  he  has  continued 
to  make  rapid  progress  and  satisfactory  improvement. 

We  are  all  subject  to  the  little  ills  of  life.  Other  people  are 
not  free  from  these  vexing  trifles ;  why  should  we  expect  to  be  ? 
In  times  of  trouble  and  harassment,  let  us  swell  out  our  chests, 
breathe  deeply,  and  face  these  trifling  difficulties  like  men.  Let 
obstacles  breed  the  spirit  of  conquest,  the  determination  to  con- 
quer, instead  of  causing  us  to  wilt  and  surrender. 

THE    CHRONIC    "  KICKING  "    HABIT 

Another  great  cause  of  worry  and  kindred  mental  dissatis- 
faction is  to  be  found  in  the  disposition  of  some  grouchy  dys- 
peptics to  find  fault  with  everything  and  everybody.  They  have 
literally  acquired  the  "  kicking  "  habit.     Such  unfortunate  creat- 


58  WORRY  AND  NERVOUSNESS 

ures  seem  utterly  unable  to  see  good  in  anybody  or  to  be  satis- 
fied with  anything.  They  manifest  constant  resistance  to  their 
environment. 

It  should  be  remembered  that  worry  grows  by  what  it  feeds 
on.  When  we  nurse  and  nourish  this  spirit  of  dissatisfaction,  it 
acts  and  reacts  upon  ourselves  until  the  very  soul  is  filled  with 
discontent,  and  the  mind  is  wholly  permeated  with  chronic  com- 
plaining. However  small  and  trifling  the  matter  over  which  we 
begin  to  worry,  this  insignificant  cause  of  our  mental  dissatis- 
faction will  be  found  entirely  sufficient  to  feed  and  nourish  the 
spirit  of  uneasiness  to  the  point  where  it  completely  gains  pos- 
session of  the  mind,  threatens  to  wreck  our  career,  and  con- 
stantly harasses  the  soul  to  the  point  where  life  is  almost  un- 
bearable. Worry  travels  and  operates  in  a  sort  of  "  vicious 
circle"  —  and  all  its  terrible  results  unfailingly  operate  as  the 
generators  of  new  forms  of  fretting  —  new  causes  for  worry. 

But  after  all  that  can  be  said  of  the  causes  of  worry,  we  can- 
not overlook  the  fact  that  some  people  have  come  to  the  place 
where  they  enjoy  poor  health.  They  would  not  be  happy  if  they 
could  not  complain  of  backache,  headache,  stomach-ache,  or 
something  of  the  kind;  their  complaints  have  become  chronic; 
they  enjoy  enlisting  the  sympathy  of  their  fellows,  having  great 
and  evident  delight  in  describing  their  sufferings  and  explaining 
their  miseries;  they  are  constantly  consulting  the  almanac  and 
patent  medicine  advertisements  to  find  some  new  cause  for 
physical  complaint,  and  thev  usuallv  find  what  they  are  looking 
for. 

An  habitual  worrier  —  an  aged  woman  —  said  to  her  physi- 
cian, "  My  head  feels  dull  like,  and  I've  kinder  lost  the  power  to 
worry  over  things."  A  great  many  people  would  be  much 
troubled  were  they  to  lose  the  power  to  worry  over  things.  They 
think  it  their  duty  to  worry.  They  would  not  feel  that  they  were 
conscientious  or  faithful  if  they  were  not  always  anxious  over 
what  they  were  doing.  They  would  not  think  they  were  showing 
the  proper  interest. 

THE    HANDICAPS   OF    WORRY 

In  cataloging  the  handicaps  of  worry,  Marden  says : 


CHRONIC  FEAR  OR  COMMON  HORRY  59 

Wc  Americans  pity  ignorant  savages  who  live  in  terror  of  their 
cruel  Gods,  their  demons  which  keep  them  in  abject  slavery,  but  we 
ourselves  are  the  slaves  of  a  demon  which  blasts  our  hopes,  blights 
our  happiness,  casts  its  hideous  shadow  across  all  our  pleasures,  de- 
stroys our  sleep,  mars  our  health,  and  keeps  us  in  misery  most  of  our 
lives. 

The  monster  dogs  us  from  the  cradle  to  the  grave.  There  is  no 
occasion  so  sacred  but  it  is  there.  Unbidden  it  comes  to  the  wedding 
and  the  funeral  alike.  It  is  at  every  reception,  every  banquet,  it 
occupies  a  seat  at  every  table. 

Xo  human  intellect  can  estimate  the  unutterable  havoc  and  ruin 
wrought  by  worry.  It  has  forced  genius  to  do  the  work  of  medi- 
ocrity ;  it  has  caused  more  failures,  more  broken  hearts,  more  blasted 
hopes  than  any  other  one  cause  since  the  dawn  of  the  world.  \\  hat 
have  not  men  done  under  the  pressure  of  worry!  They  have  plunged 
into  all  sorts  of  vice,  have  become  drunkards,  drug  fiends;  have  sold 
their  very  souls  in  their  efforts  to  escape  this  monster. 

Think  of  the  homes  which  it  has  broken  up;  the  ambitions  it  has 
ruined  ;  the  hopes  and  prospects  it  has  blighted  !  Think  of  the  suicide 
victims  of  this  demon  ! 

Many  a  strong  man  is  tied  down,  like  Gulliver,  by  Lilliputians  — 
bound  hand  and  foot  by  the  little  worries  and  vexations  he  has  never 
learned  to  conquer. 

We  borrow  trouble;  endure  all  our  lives  the  woe  of  crossing  and 
recrossing  bridges  weeks  and  years  before  we  come  to  them;  antici- 
pate our  drudgery  and  consequently  suffer  from  the  apprehension 
of  terrible  things  that  never  happen. 

I  know  women  who  never  open  a  telegram  without  trembling,  for 
they  feel  sure  it  will  announce  the  death  of  a  friend  or  some  terrible 
disaster.  If  their  children  have  gone  for  a  sail  or  a  picnic,  they  are 
never  easy  a  moment  during  their  absence;  they  work  themselves 
into  a  fever  of  anxiety  for  fear  that  something  will  happen  to  them. 
Many  a  mother  fritters  away  more  energy  and  useless  frets  and 
fears  for  her  children,  a  nervous  strain  over  this  or  that,  than  she 
uses  for  her  daily  routine  of  domestic  work.  She  wonders  why  she 
is  so  exhausted  at  the  close- of  the  day,  and  never  dreams  that  she 
has  thrown  away  the  greater  part  of  her  force.  Look  at  the  women 
who  are  shriveled  and  shrunken  and  aged  at  thirty,  not  because  of 
the  hard  work  they  have  done,  or  the  real  troubles  they  have  had, 
but  because  of  habitual  fretting,  which  has  helped  nobody,  but  has 
brought  discord  and  unhappiness  to  their  homes. 

Worry  not  only  saps  vitality  and  wastes  energy,  but  it  also  seri- 


60  WORRY  AND  NERVOUSNESS 

ously  affects  the  quality  of  one's  work.  It  cuts  down  ability.  A  man 
cannot  get  the  same  quality  of  efficiency  into  his  work  when  his  mind 
is  troubled.  The  mental  faculties  must  have  perfect  freedom  before 
they  will  give  out  their  best. 

It  is  the  little  pin-pricks,  the  petty  annoyances  of  our  every  day 
life,  that  mar  our  comfort  and  happiness  and  rob  us  of  more  strength 
than  the  great  troubles  which  we  nerve  ourselves  to  meet.  It  is  the 
perpetual  scolding  and  fault-finding  of  an  irritable  man  or  woman 
which  ruins  the  entire  peace  and  happiness  of  many  a  home. 

THE   WASTE   OF   WORRY 

Worry  is  always  a  waste,  always  a  disease.  Physically,  it  is 
traceable  in  drawn  features,  short  breathing,  tense  bearing,  ir- 
regular quick  movements.  Mentally,  it  is  distinguishable  as  a 
vicious  circle  of  the  intellect  and  the  emotions,  thought  and 
feeling  futilely  rotating  about  some  single  object  set  out  of 
focus.  Sometimes  a  trifling  difficulty  or  risk  swells  to  a  moun- 
tain, some  little  business  loss,  some  slight  personal  affront  or 
passing  ailment  is  bloated  out  by  apprehension  until  it  occupies 
the  mind,  becomes  a  fixed  idea,  even  an  obsession. 

When  there  is  no  irritant  at  hand,  worry  finds  or  invents  its 
object,  setting  the  imagination  to  fabricate  troubles  and  griev- 
ances out  of  any  casual  material  of  life.  Such  anxiety  or  appre- 
hension as  relates  to  matters  of  real  weight  for  which  we  have 
true  responsibility  cannot  be  regarded  as  worry;  this  sort  of 
emotion  rightly  measured  and  directed,  is  a  prophylactic  evolved 
for  the  preservation  of  the  individual  and  the  race.  Worry  is 
essentially  irrational,  and  it  is  literally  true  that  nothing  kills  so 
sure  as  care.  We  must  come  to  recognize  that  even  self-pity  is 
only  a  refined  form  of  sensitiveness  or  selfishness. 

Outside  of  the  contagious  and  infectious  diseases  and  certain 
organic  degenerations,  it  is  highly  probable  that  at  least  nine- 
tenths  of  all  human  suffering  originates  in  the  mind.  These 
trifling  causes  grow  in  the  mind  and  expand  in  the  physical 
realms  until  their  victims  are  suffering  from  well-defined  neuras- 
thenia, dyspepsia,  loss  of  weight,  anaemia,  sluggish  circulation, 
high  blood-pressure,  hypochondria,  headache,  arteriosclerosis, 
pale  skins,  constipation,  apoplexy,  heart  failure,  paralysis,  hys- 
teria, and  premature  old  age. 


CHROXIC  FEAR  OR  COMMOX  WORRY  61 

The  results  of  chronic  worry  are  equally  destructive  on  char- 
acter development.  It  paralyzes  the  creative  powers  of  the  in- 
tellect. It  generates  a  pessimistic  outlook  on  the  battlefield  of 
life,  it  smokes  our  social  field  glass,  and  blurs  over  views  of  rela- 
tionship to  our  fellows.  From  both  the  psychic  and  physical 
standpoints  worry  constitutes  a  vital  leakage  —  an  insidious  seep- 
ing of  one's  vital  energies  —  demonstrating  in  the  end  that 
"  fretting  "  is  a  far  worse  foe  to  human  health  and  happiness 
than  "  fatigue." 

SUMMARY    OF    THE    CHAPTER 

1.  Worry  may  be  defined  as  "chronic  fear,"  "spasm  of  the 
attention,"  or  over-concentration.  Worry  is  fear-thought  in 
contradistinction  to  forethought.  It  is  a  process  of  borrowing 
trouble  from  the  future  to  augment  our  present  sorrows. 

2.  The  tendency  to  worry  exists  only  in  those  animals  high 
enough  up  in  the  biologic  scale  to  possess  associative  memories. 
Man  possesses  a  high  degree  of  memory  association,  and,  there- 
fore, of  all  animals,  makes  himself  most  ridiculous  by  worry. 

3.  Man  is  not  content  to  suffer  as  a  mere  brute,  physically,  but 
to  this  material  distress  he  adds  imaginary  suffering. 

4.  The  one  great  cause  of  worry  is  the  universal  desire  for 
happiness,  and  the  quest  for  those  things  and  conditions  which 
are  generally  supposed  to  confer  happiness  on  their  possessor. 

5.  Worry  results  from  some  form  of  nervous  irritation  — 
coupled  with  anxiety,  fear,  and  a  marked  lack  of  self-control. 

6.  Worry  springs  from  one  or  the  other  of  those  all  embracing 
human  sentiments  —  desire  and  fear. 

7.  Many  good  people  constantly  worry  because  of  their  tem- 
peramental peculiarities.  They  feel  that  they  are  always  being 
"  neglected,''  "  slighted,"  or  "  criticised."  Others  are  inordi- 
nately timid,  backward,  and  bashful. 

8.  Some  people  are  literally  human  barometers.  They  con- 
stantly worry  over  the  weather  —  also  sun  spots,  comets,  etc. 

9.  "  Making  mountains  out  of  mole  hills  "  has  come  to  be  the 
regular  business  of  some  folks.  They  magnify  the  smallest 
trifles  beyond  all  measure  and  reason. 

10.  Many  lives  are  almost  completely  wrecked  by  inordinate 
worry  over  some  youthful  blunder,  some  early  indiscretion. 
They  need  to  reverse  the  spy  glass  of  life. 

11.  Some  people  have  acquired  the  chronic  "kicking  habit." 
They  see  no  good  in  anybody  and  are  dissatisfied  with  every- 
thing that  happens.  They  are  in  a  state  of  constant  environ- 
mental resistance. 


62  WORRV  AND  NERVOUSNESS 

12.  Certain  chronic  worriers  come  to  that  sorry  pass  where 
they  actually  enjoy  poor  health,  taking  evident  delight  in  reciting 
their  complaints  and  sufferings. 

13.  Worry  is  a  legacy  of  fear  handed  down  from  the  savages 
of  old,  and  yet  modern  civilization  permits  this  barbaric  mental 
attitude  to  play  havoc  with  and  almost  overturn  the  peace  and 
happiness  of  modern  society. 

14.  Many  a  nervous  woman  expends  more  energy  in  foolish 
worry  over  the  minor  trifles  of  the  daily  life  than  she  devotes  to 
the  solution  of  the  real  and  major  problems  of  family  and  social 
life. 

15.  Worry  is  a  tremendous  social,  moral,  physical,  and  eco- 
nomic waste     It  is  literally  true  that  nothing  kills  so  sure  as  care. 

16.  Worry  is  responsible  for  nine-tenths  of  human  suffering 
and  disease  —  if  we  exempt  those  afflictions  caused  by  microbes 
and  the  natural  degenerations  accompanying  old  age. 

17.  Chronic  worry  exacts  a  physical  toll  embracing  disturb- 
ances of  circulation,  digestion,  and  the  nerves;  including  head- 
ache, high  blood-pressure,  constipation,  apoplexy,  neurasthenia, 
hysteria,  and  hypochondria. 

18.  Self-pity  is  a  refined  form  of  sensitiveness  or  selfishness. 


CHAPTER   VI 
COMMON   CAUSES  OF  WORRY   AXD   NERVOUSNESS 

IT  IS  now  in  order  to  consider  some  of  the  common  causes  of 
chronic  worry  and  nervousness,  with  a  view  to  discovering 
how  to  suppress  the  operation  of  these  same  causes  —  and  thus 
to  prevent  this  worry  and  nervousness.  The  ideal  method  of 
treatment  for  these  psychic  and  neurological  disorders  is  to 
discover  how  effectively  to  "  nip  the  trouble  in  the  bud." 

On  this  score  certain  writers,  both  lay  and  medical,  attempt  to 
dispose  categorically  of  what  is,  in  reality,  a  complex  problem, 
by  holding  the  general  strenuousness  of  modern  American  life 
alone  to  blame  for  all  cases  of  disordered  nerves.  Properly  de- 
fined, the  strenuous  life  is  merely  one  of  strong  effort  and  exer- 
tion. And  strong  effort,  rightly  controlled  and  directed,  never 
occasions  undue  wear  and  tear  upon  the  nervous  system. 

As  a  matter  of  fact,  cases  of  nervous  breakdown  in  which 
neither  acquired  nor  hereditary  predisposition  is  discoverable  are 
very  rare  indeed.  So  that,  for  the  most  part,  causes  which  are 
held  to  be  direct  —  notably  exhausting  illness  of  all  kinds,  surgi- 
cal operations  upon  the  appendix  or  upon  the  reproductive  or- 
gans, and  severe  and  protracted  childbirth  —  do  little  more  than 
to  precipitate  the  disaster. 

EARLY    NEUROTIC    INFLUENCES 

Not  infrequently,  the  foundation  for  a  life-long  career  of 
nervousness  is  laid  in  early  childhood  by  the  thoughtless  and 
ignorant  methods  of  child  culture,  which  so  largely  prevail.  Re- 
garding this  matter,  Dubois  has  written : 

In  many  cases  the  seeds  of  nervous  breakdown  are  sown  in  very 
early  life.  Through  the  ignorance  of  nursemaids,  parents  or  guard- 
ians, vivid  impressions  of  a  terrifying  or  otherwise  obnoxious  nature 
are  constantly  made  upon  the  child  mind,  which  sadly  interfere  with 

63 


64  WORRY  AND  NERVOUSNESS 

the  firm  upbuilding  of  character  so  essential  to  the  stability  and 
functional  harmony  of  the  nervous  system. 

But  many  parents,  failing  to  take  the  cue  from  Nature,  insist  on 
thwarting  her  beneficent  efforts  by  requiring  their  reluctant  offspring 
to  not  only  devote  more  time  to  their  studies  than  is  necessary,  but 
also  to  spend  several  nerve  racking  hours  daily  in  practice  upon  some 
musical  instrument. 

Some  very  young  children  are  still  given  such  rank  nerve  poisons 
as  tea,  coffee,  and  alcohol,  by  ignorant  parents  of  the  poorer  classes, 
but  popular  medical  instruction  has  done  much  to  lessen  this  evil. 

From  the  age  of  puberty  up  to  the  time  a  youth  or  maiden  reaches 
maturity,  overstudy  is  the  predisposing,  as  well  as  the  direct,  cause 
of  disordered  nerves  in  a  certain  number  of  cases.  But  it  is  a  cause 
of  minor  importance  in  every  way  as  compared  with  certain  experi- 
ences that  may  be  undergone  at  the  time  when  the  sexual  instinct 
begins  to  intrude  itself  forcibly  upon  consciousness. 

Through  the  ignorance,  indifference  or  mawkish  sentimentality  of 
parents,  many  a  youth  comes  into  the  possession  of  procreative  pow- 
ers, the  physical,  mental  and  moral  significance  of  which  he  under- 
stands nothing.  If  he  is  of  vigorous  bodily  habit  and.  at  the  same 
time,  clean-minded,  he  may  for  a  long  time  resist  Nature's  prompt- 
ings. But  Nature  is  imperious,  while  instinctive  morality  is  at  most 
only  rudimentary  and  puts  but  a  feeble  check  upon  an  organic  long- 
ing. Under  such  conditions  the  habit  of  self-pollution  is  easily  estab- 
lished. Once  established,  it  may  be  continued  for  years;  and  indeed, 
without  perceptible  detriment  to  mind  or  body.  In  the  generality  of 
cases,  however,  there  comes,  sooner  or  later,  a  rude  awakening. 
Through  the  talk  of  ignorant  lay  acquaintances,  or  far  worse  still, 
through  the  unspeakable  pernicious  literature  which  is  scattered 
broadcast  by  the  most  ruthless  of  all  human  vultures,  the  "  Lost 
Manhood  "  quacks,  the  victim  of  the  habit  becomes  obsessed  with 
the  idea  that  he  has  ruined  himself  mentally  and  physically.  Even 
in  cases  where  no  such  habit  is  formed,  and  the  youth  experiences 
nothing  worse  than  nocturnal  pollutions  of  varying  frequency, 
it  is  instilled  into  his  mind  by  these  same  fiends  that  this  perfectly 
natural  phenomenon  leads  inevitably  to  equally  terrible  results. 
In  consequence  of  this  disingenuous  enlightenment  real  evils,  such 
as  worry,  anxiety,  introspection  and  self-analysis,  spring  rapidly 
into  existence  and  make  easy  the  descent  into  the  hell  of  disordered 
nerves. 

In  the  case  of  a  girl,  the  situation  is  different.  If  she  is  not 
properly  prepared  for  its  advent,  the  first  menstrual  epoch  may  bring 


CAUSES  OF  WORRY  65 

with  it  an  emotional  crisis  which  may  recur  with  each  successive 
epoch. 

Life  between  the  ages  of  puberty  and  maturity  is  fraught  with  still 
further  menaces  to  nervous  stability,  and  among  the  more  common 
are  the  tea,  coffee,  tobacco  and  alcohol  habits,  in  all  of  which  the 
balance  between  nervous  waste  and  repair  is  constantly  disturbed. 
This  balance  is  likewise  disturbed  by  either  work  or  pleasure-seeking, 
whenever  the  one  or  the  other  constantly  interferes  with  sound 
nightly  sleep  of  nine  or  ten  solid  hours. 

For  the  girl  who  is  popular  there  is  the  eternal  round  of  dances, 
theaters  and  house  parties  and  other  forms  of  social  activity,  which 
make  such  severe  demands  upon  her  physically  and  emotionally  that, 
by  the  time  she  "  comes  out,"  her  fund  of  nerve  force  is  often  at  a 
low  ebb. 

THE    WORRY    CIRCLE 

When  the  attention  is  directly  concentrated  upon  any  part  of 
the  body,  there  is  a  definite  tendency  to  magnify  the  sensations 
arising  in  that  part.  Special,  peculiar,  or  unusual  physical  sen- 
sations always  have  a  tendency  to  engender  more  or  less  fear; 
and  it  is  a  well  known  and  generally  recognized  fact  of  psychol- 
ogy, that  fear  unfailingly  both  increases  and  focalizes  the  at- 
tention. 

Sensation,  fear,  and  attention  constitute  the  elements  which 
enter  into  the  formation  of  that  wicked  and  destructive  mischief- 
maker  the  "  vicious  worry  circle."  It  will  be  recalled  that  one 
of  the  definitions  of  worry  was,  "  a  spasm  of  the  attention." 
This  health-destroying  and  mind-ruining  "  circle  of  worry " 
starts  with  some  extraordinary  conscious  impression,  upon  which 
the  attention  is  forthwith  focussed.  The  vividness  of  the  im- 
pression is  thereby  greatly  increased  and  fear  is  aroused,  per- 
haps worry  is  born.  Then  all  this  fear  and  worry  reacts  by 
increasing  and  focalizing  the  attention  anew  upon  those  impres- 
sions which  were  the  original  source  and  cause  of  all  this  mis- 
chief. In  this  manner,  concentration  of  the  thoughts  upon  any 
of  the  internal  organs  of  the  body  or  upon  any  local  pain,  is  usu- 
ally found  to  make  matters  decidedly  worse  or  indefinitely  to 
perpetuate  the  ailment. 

It  would  thus  appear  that  worry  is  seldom  likely  to  cure  itself 


66  WORRY  AND  NERVOUSNESS 

by  being  allowed  to  run  its  natural  course.  It  soon  wears  for 
itself  definite  grooves  in  the  brain  and  nervous  system,  and  ever 
tends  to  perpetuate  itself  after  the  manner  of  this  "  vicious  cir- 
cle," and  in  almost  every  case  slowly  but  surely  increases  its 
intensity,  thereby  becoming  more  and  more  destructive  to  mental 
peace  and  physical  health.  We  would  not  dispute  the  fact  that 
the  meek  and  humble  soul-eyed,  hollow-cheeked  woman  may  be 
on  the  certain  road  to  heaven,  but  we  are  quite  certain  that  she 
must  have  a  "  stop  over  ticket  for  some  sanitarium  "  or  hospital 
where  she  will  have  to  be  long  treated  for  the  mental  and  mate- 
rial results  of  her  constant  worry,  as  well  as  for  the  indigestion, 
dysp<  psia  and  nervous  prostration,  that  are  so  surely  produced 
by  this  unnatural,  unhealthful  and  downcast  mental  state.  And 
so,  the  "  vicious  worry  circle  "  is  found  to  consist  of  the  follow- 
ing factors  —  attention  magnifies  sensation;  sensation  produces 
tear  and  worry  ;  and  the  worry  still  further  increases,  and  in- 
t<  unifies,  and  focalizes  the  attention. 

EXCESSIVE    SELF-CONSCIOUSNESS 

Among  the  everyday  mental  causes  for  fear  and  worry  should 
be  mentioned  the  exaggerated  self-consciousness  found  especially 
in  the  case  of  certain  young  people.  Stage-fright  is  an  acute 
exhibition  of  this  form  of  mental  uneasiness  and  physical  dis- 
comfort. Many  sensitive  persons  find  it  almost  impossible  to  get 
away  from  these  insistent  feelings  of  self-consciousness.  Their 
minds  are  peculiarly  concentrated  on  the  thought  that  other 
people  are  thinking  about  them,  and  all  this  certainly  is  a  dem- 
onstration of  the  fact  that  our  thoughts  are  a  real  part  of  our- 
selves. 

We  well  remember  hearing  some  one  say  '*  an  imaginary 
worry  may  be  unreal,  but  a  worried  imagination  is  the  realest 
thing  in  the  world."  The  basis  of  our  worry  may  be  entirely 
false  and  unreal,  but  the  final  results  of  the  worry  upon  the 
mind,  soul,  and  health  are  in  every  sense  real  and  highly  injur- 
ious. 

MENTAL  WORK  AND  REST 

We  must  learn  to  strike  an  intelligent  balance  between  the 
dangers  which  threaten  us  on  the  one  hand  from  too  much  work 


CAUSES  OF  WORRY  67 

and  the  friction  attendant  thereon ;  and,  on  the  other  hand, 
from  too  much  rest  and  the  rust  of  character  which  is  sure  to 
follow.  We  do  not  want  either  to  "  worry  out  "  or  "  rust  out,'' 
but  to  possess  that  wisdom  which  will  enable  us  to  lead  the 
normal,  rational  life  which  promises  deliverance  from  the  threat- 
ened dangers  of  both  these  unnecessary  extremes.  We  must  be 
able  to  strike  a  practical  working  balance  between  friction  and 
rust. 

Both  mental  idleness  and  physical  inactivity  predispose  to 
worry.  Those  who  would  cease  from  worry  must  constantly 
guard  against  intellectual  inactivity;  for,  if  it  is  true  that  Satan 
finds  mischief  for  idle  hands,  it  is  even  more  true  that  he  is 
sure  to  find  worry  for  the  idle  minds ;  and  worry  obscures  our 
outlook  on  life,  both  for  this  world  and  the  next ;  it  throttles 
the  higher  powers  of  the  mind,  it  beclouds  our  view  of  life  and 
distorts  our  appreciation  of  the  duties  thereof.  Worry  is  the 
smoke  on  the  field-glass  of  life,  and  quite  effectively  it  blurs 
our  outlook  and  paralyzes  all  the  creative  faculties  of  the  in- 
tellect. 

Mental  work  never  kills.  Mental  work  plus  worry  is  highly 
destructive  to  strength  of  brain  and  health  of  the  body;  while 
heavy  and  taxing  mental  work  coupled  with  unusual  worry 
and  its  resultant  insomnia,  presents  conditions  which  will  more 
quickly  destroy  the  physical  health  and  break  down  the  mind 
than  any  other  possible  combination  of  mental  vices  and  physical 
sins. 

In  reality,  the  nervous  system  is  seldom  thus  depleted  of  its 
forces  if  due  heed  is  given  to  even  the  most  elementary  laws 
of  hygiene,  and  the  reaction  of  daily  toil  upon  the  individual's 
consciousness  is  a  pleasant  one.  Depletion  follows  only  where 
such  common  physical  needs  as  nourishing  food,  pure  air,  sun- 
shine and  sleep  are  practically  neglected,  and  the  energies  of 
mind  and  body  are  incessantly  bent  upon  some  daily  task  whose 
chief  emotional  reaction  is  worry. 

In  the  last  analysis,  the  most  important  factor  in  the  direct 
causation  of  nervous  exhaustion  is  the  emotional  life  of  the 
individual  Where  worry  is  the  dominant  note,  breakdown  is 
practically  inevitable. 


68  WORRY  AND  NERVOUSNESS 

THE  "  SPIRIT  OF  INFIRMITY  " 

And,  behold,  there  was  a  woman  which  had  a  spirit  of  infirmity 
eighteen  years,  and  was  bowed  together,  and  could  in  no  wise  lift 
up  herself.  And  when  Jesus  saw  her,  He  called  her  to  Him,  and 
said  unto  her,  Woman,  thou  art  loosed  from  thine  infirmity.  And 
He  laid  His  hands  on  her ;  and  immediately  she  was  made  straight, 
and  glorified  God.    (Luke  XIII:n-i3.) 

Here  was  an  unfortunate  sufferer  who  had  been  held  in 
bondage  by  an  imaginary  "  spirit  of  infirmity  "  for  almost  a  score 
of  years.  The  Master  broke  light  into  her  darkened  mind  by 
announcing  that  she  was  free  from  her  infirmity.  She  had  never 
been  really  bound.  She  was  bowed  together  as  a  result  of  her 
long  worry  and  sorrow.  So  long  had  she  assumed  this  physical 
attitude  that  her  body  had  become  permanently  deformed  —  an- 
other illustration  of  a  serious  physical  disorder  resulting  from 
purely  mental  causes. 

Thousands  of  suffering  souls  are  held  today  by  the  chains  of 
imaginary  bondage.  They  have  no  real  physical  disease.  Their 
ailment  is  in  reality  only  a  "  spiritual  infirmity."  They  might 
go  free  at  any  time,  but  they  do  not  know  it;  they  will  not  be- 
lieve it.  These  prisoners  of  despair  are  held  securely  in  their 
prison  house  of  doubt  by  the  force  of  fear  and  habit.  They  are 
very  much  like  the  elephant  in  Central  Park,  Xew  York  City, 
which  had  stood  in  one  spot  for  many  years,  shackled  with  heavy 
chains.  He  had  never  left  his  tracks  except  when  he  had  been 
unfastened  and  led  away  by  his  keepers.  One  day  it  occurred  to 
them  to  remove  the  fetters  from  his  legs  and  see  if  he  would 
leave  his  place.  After  the  beast  was  free  from  his  shackles, 
he  steadfastly  refused  to  move,  even  after  he  was  allowed  to 
become  exceedingly  hungry,  and  when  food  was  placed  within 
a  few  inches  of  his  reach,  he  stood  in  his  tracks  swaying  from 
side  to  side  and  trumpeting  loudly,  but  not  a  step  did  the  huge 
beast  take  toward  the  food. 

The  elephant  was  free,  but  he  did  not  know  it;  therefore  he 
stood  there  in  his  old  place  just  as  securely  bound  by  the  chains 
of  his  own  mind  as  if  the  steel  bands  were  about  him  as  of  old. 
And  so  it  is  with  humanity ;  altogether  too  many  of  us  are  like 
unto  the  elephant,  we  are  absolutely  free  today,  but  not  realizing 


CAUSES  OF  WORRY  69 

or  not  believing  the  glorious  fact  —  not  having  faith  and  cour- 
age enough  to  step  out  into  our  mental  freedom  and  begin  to 
enjoy  our  spiritual  liberty  —  like  the  elephant,  we  stand  in  the 
place  of  habit-bondage  and  bitterly  mourn  our  terrible  fate. 
We  are  not  surprised  when  an  elephant  behaves  this  way,  but 
it  ought  to  be  a  cause  for  great  astonishment  that  intelligent 
men  and  women,  sons  and  daughters  of  God,  will  allow  them- 
selves to  be  held  down  by  fictitious  bondage  and  bound  down  by 
a  mere  "  spirit  of  infirmity.'' 

FICTITIOUS    WORRIES 

We  recently  saw  a  picture  which  greatly  impressed  us  con- 
cerning the  uselessness  of  worry.  It  was  a  picture  of  an  old 
man,  bent  in  form,  sad  of  expression,  suggestive  of  a  life  filled 
with  perplexities  and  anxiety;  and  underneath  the  picture  was 
this  statement;  "I  am  an  old  man  and  have  had  many,  many 
troubles  —  most  of  which  never  happened." 

A  recent  writer  in  discussing  the  question  of  worry  and  the 
weakened  condition  of  the  mind  which  permits  the  "  worry 
circle  "  to  go  on  forever  revolving,  getting  worse  and  worse  puts 
it  very  aptly  as  follows :  "  You  say  you  cannot ;  your  friends 
say  you  will  not;  the  truth  is,  you  cannot  will."  There  is  need 
on  the  part  of  most  persons  of  a  determined  effort  to  strengthen 
the  will,  to  control  the  mind.  The  methods  for  the  accomplish- 
ment of  this  will  be  discussed  in  another  chapter  and  in  connec- 
tion with  the  treatment  of  worry. 

Certain  nervous  diseases  are  caused  by  worry.  Most  impor- 
tant among  these  is  the  condition  known  as  neurasthenia,  com- 
monly called  "  nervous  prostration."  Patients  suffering  from 
this  condition  are  usually  spoken  of  as  "  all  run  down."  The 
truth  is  that  they  are  patients  who  have  been  "  all  wound  up," 
and,  as  a  result  of  high  tension,  coupled  with  mental  anxiety, 
they  have  broken  down  —  collapsed. 

Hypochondria  is  another  disease  which  owes  its  origin  and 
perpetuation  largely  to  worry.  Hypochondria  is  simply  a  con- 
dition in  which  one  worries  about  having  other  diseases.  When- 
ever the  most  intelligent  of  men  begin  to  examine  their  mental 
Dr  physical  life,   they  usually  discover  themselves  to  be   sick. 


70  WORRY  AND  NERVOUSNESS 

Some  one  has  truthfuly  said;  "we  are  all  afflicted  with  a  dis- 
ease called  life.'*  This  is  a  form  of  hypochondria  which  it  is 
entirely  possible  to  cure  by  mental  means.  There  is  another 
kind  of  hypochondria  which  usually  requires  the  cooperation 
of  the  physician  for  its  permanent  removal.  A  third  form  of 
nervous  complaint  largely  due  to  worry  and  anxiety  is  hysteria ; 
and  hysteria,  it  should  be  remembered  is  the  impersonator  of 
almost  every  known  disease. 

MORAL  CAUSES  OF  WORRY 

The  moral  habits  and  spiritual  state  of  the  individual  not 
infrequently  contribute  much  toward  the  production  of  worry. 
Sin  is  not  only  a  cause  of  physical  sickness,  but  it  also  lies  at 
the  bottom  of  many  a  mental  malady.  Immorality,  dishonesty, 
and  intemperance,  all  operate  to  destroy  the  peace  of  mind, 
while  they  give  rise  to  that  prick  of  conscience  which  is  alto- 
gether incompatible  with  a  tranquil  mental  state. 

Religion  may  be  either  a  cause  of  worry,  or  it  may  play  the 
role  of  a  cure.  We  speak  of  "  religion  "  in  the  sense  of  some 
particular  form  of  theological  belief. 

Worry  is  frequently  generated  by  false  ideas  and  arbitrary 
views  of  the  Supreme  Being.  Doctrinal  and  interpretative 
errors  of  religious  beliefs  are  responsible  for  much  of  the  down- 
cast and  despondent  experience  of  thousands  who  do  not  pro- 
fess to  be  followers  of  the  Christ.  Many  earnest  and  honest 
souls  have  such  constant  wrestlings  with  the  doubt  of  the  for- 
giveness of  their  sins,  or  they  live  in  such  incessant  fear  of 
death  and  eternal  damnation,  that  the  mind  is  held  in  constant 
bondage  to  these  insistent  and  oppressive  thoughts,  and  all  this 
must  inevitably  result  in  the  production  of  a  chronic  state  of 
worry  and  nervousness. 

RELIGIOUS  FANATICISM 

Religious  devotion  and  faith,  while  they  may  prove  the  quick 
and  certain  cure  for  some  forms  of  worry,  may  also  be  per- 
verted—  carried  to  such  fanatical  extremes  as  to  produce  se- 
rious mental  worry  and  even  spiritual  despondency.  Every  now 
and  then,  we  hear  of  some  one  "  going  crazy  over  religion." 


CAUSES  OF  WORRY  71 

Such  a  one  usually  belongs  to  that  class  of  morbidly  conscien- 
tious and  overscrupulous  people  who  possess  a  nervous  system 
already  greatly  weakened;  or  perhaps  they  have  a  strain  of 
insanity  in  their  family,  and  probably  some  of  their  ancestors 
were  alcoholic  or  syphilitic.  The  combination  of  such  physical 
soil,  taken  together  with  the  unusual  mental  strain  or  excite- 
ment, connected  with  extraordinary  religious  enthusiasm,  is 
frequently  able  suddenly  to  overturn  the  mind  or  else  to  pro- 
duce such  an  unnatural  condition  of  anxiety  and  worry  as  grad- 
ually to  undermine  the  mental  vigor  and  result  in  producing 
some  form  of  insanity.  Religious  fanaticism  is  simply  one- 
sided moral  reasoning,  simply  the  extreme  over-emphasis  of 
one  aspect  of  the  religious  or  moral  life.  It  sometimes  results 
from  an  apparent  exhaustion  of  the  mental  energies  and  over- 
work of  the  spiritual  faculties. 

Still  other  sincere  persons  are  suffering  from  the  results  of 
their  own  misguided  zeal.  They  voluntarily  possess  themselves 
of  such  extraordinary  burdens  for  the  salvation  of  the  souls 
of  their  fellow  men,  that  they,  in  a  measure  actually  assume 
the  worry  and  responsibility  of  the  world's  Saviour ;  and.  as  a 
result,  their  brains  are  overburdened,  and  their  souls  are  crushed 
beneath  the  weight  of  this  constant  worry  and  anxiety  for 
the  welfare  of  their  fellows.  Religious  hope  of  the  right  sort, 
when  sincerely  cherished,  undoubtedly  exercises  a  positive  power 
toward  the  prevention  of  worry.  It  is  an  important  observa- 
tion which  the  author  is  not  alone  in  making,  that  as  the  so- 
called  old  fashioned  religion  declines,  worry  increases.  As 
men  and  women  depart  from  the  simple  faith  and  trust  in  the 
fundamental  principals  of  the  Christian  religion,  there  is  a 
growing  tendency  to  worry.  We  sincerely  believe  that  the 
religion  of  the  soul  should  be  as  a  bright  light  shining  in  a 
•  lark  place,  our  guiding  star  instead  of  being  perverted  into  a 
source  of  worry,  grief,  and  despondency. 

PHYSICAL   CAUSES  OF  WORRY 

Many  sensitive  souls  are  caused  more  or  less  worry  through- 
out life  by  the  legacies  handed  down  by  father  and  mother 
in   the   shape   of   physical   weaknesses    and  bodily   deformities. 


72  WORRY  AXD  NERVOUSNESS 

Still  others,  owing  to  a  weakened  nervous  system  and  over- 
strain, have  fallen  into  a  condition  of  nervous  irritability  that 
renders  them  very  liable  to  anxiety  and  worry  upon  the  least 
provocation.  Such  persons  —  in  fact  all  of  us  —  are  greatly 
predisposed  to  worry  by  sleeplessness.  Sound  sleep  is  a  great 
preventive  of  the  mental  state  that  borders  on  worry  and 
nervousness. 

The  state  of  the  physical  health  is  not  an  infrequent  occasion 
for  worry.  Many  worry  because  of  the  lingering  illness  or 
unusual  afflictions,  while  others  grieve  because  of  the  sickness 
and  suffering  of  their  loved  ones. 

There  is  little  doubt  that  nine-tenths  of  all  the  ordinary  non- 
contagious diseases  of  the  body  originate  in  the  mind,  and  it  is 
worry  that  produces  the  soil  from  which  these  infant  disorders 
spring.  The  seeds  of  mental  disease  and  physical  affliction 
may  fall  upon  us  thick  and  fast,  but  if  they  fail  to  find  the  soil 
of  worry  and  depression  in  which  to  develop  and  grow,  we  are 
not  likely  to  be  seriously  affected  by  their  presence.  It  requires 
not  only  a  germ  to  produce  disease,  but  also  a  favorable  soil 
in  which  it  may  grow.  Worry  produces  just  that  condition  of 
mind  and  body  most  favorable  to  the  growth  and  development 
of  all  the  vicious  diseases  which  prey  upon  the  mind  and  destroy 
the  body. 

WORRY  DEPENDENT   ON   AGE 

Many  of  the  worries  which  afflict  the  human  mind  are  inci- 
dent to  some  particular  time  of  life  —  they  are  more  or  less 
dependent  on  age.  For  example,  we  have  certain  worries  be- 
longing to  the  period  of  childhood,  others  to  adolescence.  Cer- 
tain difficulties  are  more  likely  to  harass  the  soul  during  the 
adult  period  of  life,  whereas  other  troubles  are  more  likely  to 
give  birth  to  worry  and  anxiety  during  old  age.  The  worries 
of  childhood  are  just  as  real  as  those  of  later  life.  The  little 
girl  who  is  made  to  wear  short  dresses  which  come  consider- 
ably above  her  knees,  when  she  has  long  outgrown  them;  or 
the  small  boy  who  is  compelled  to  wear  clothes  which  he  regards 
as  suited  only  to  infants  —  both  have  their  worries ;  and  it  should 
be  remembered  that  their  childish  grievances  are  to  them  very 


CAUSES  OF  WORRY  73 

real.  They  take  these  little  troubles  of  childhood  very  seriously. 
Likewise  their  griefs  and  sorrows  resulting  from  ridicule  and 
teasing  tend  to  induce  unhealthy  mental  activity,  and  seriously 
to  warp  the  nervous  system  in  its  early  development. 

Another  form  of  worry  which  may  be  properly  classified 
among  this  group,  is  the  fear  and  worry  of  old  age.  As  the 
years  pass  over  us,  the  arteries  begin  to  harden,  the  memory 
gradually  fails,  the  skin  becomes  visibly  wrinkled,  and  leath- 
ery, and  old  age  brings  its  peculiar  worries  to  the  majority  of 
people.  There  is  a  tendency  to  undue  anxiety  on  the  part  of 
the  aged  that  is  born  both  of  the  retrospective  view  of  life 
and  anticipation  as  to  what  the  future  holds  in  store.  Especially 
is  this  true  in  the  case  of  those  who  do  not  have  sufficient  means 
laid  up  properly  and  comfortably  to  care  for  them  to  a  good 
old  age. 

PERNICIOUS    HEALTH    FADS 

Some  new  fangled  health  fad  may  set  the  whole  country 
worrying  about  dietetics  and  dyspepsia.  Newspaper  articles  and 
health  literature  are  able  so  to  alarm  the  people  as  markedly  to 
upset  the  nerves  and  digestion  of  thousands  of  susceptible  per- 
sons. Some  editorial  novice,  who  cannot  earn  his  living  in  a 
better  way,  sends  out  an  article  to  the  newspaper  syndicate 
proclaiming  that  some  scientist  has  discovered  that  straw- 
berries are  poisonous ;  and  forthwith  ten  thousand  people  begin 
to  have  stomach  trouble  from  eating  strawberries,  or  begin 
seriously  to  worry  over  their  liability  to  disagree  with  them. 
Some  persons  cannot  read  a  book  on  health  and  hygiene  with- 
out immediately  acquiring  a  new  disease.  It  is  proverbial  that 
medical  students  are  prone  to  have,  or  at  least  to  think  they 
have,  the  numerous  diseases  which  they  study  from  time  to 
time.  It  will  be  a  miracle  if  some  healthy,  but  self-conscious 
souls  do  not  get  hold  of  this  book  and  —  taking  some  part 
too  seriously  —  straight  away  proceed  to  get  nervous  or  begin 
to  worry  about  themselves. 

The  author  would  not  have  it  understood  that  he  in  any  way 
decries  the  good  that  has  been  and  is  being  accomplished  by 
the  great  hygienic  awakening  which  is  making  its  way  over  the 


74  WORRY  AND  NERVOUSNESS 

land;  we  believe  that  human  beings  should  be  capable  of  study- 
ing about  themselves  for  the  purpose  of  gaining  needed  instruc- 
tions without  allowing  their  minds  to  become  morbid,  faddish, 
and  filled  with  worry  concerning  their  physical  health. 

Xot  only  are  numerous  physical  conditions  responsible  for 
worry,  but  it  should  be  remembered  that  numerous  physical 
disorders  may  directly  result  from  chronic  worry.  Among  the 
common  physical  ailments  which  may  directly  result  from  long 
continued  worry  may  be  mentioned,  insomnia,  loss  of  weight, 
anaemia,  rise  of  blood-pressure,  hardening  of  the  arteries,  pre- 
mature old  age,  apoplexy,  headaches,  dyspepsia,  constipation, 
pale  skin,  poor  circulation,  and  predisposition  to  catching  all 
contagious  diseases  including  common  colds. 

SOCIAL   SOURCES   OF   WORRY 

Among  the  social  causes  of  worry,  family  trouble,  either  real 
or  false,  probably  comes  fir>t.  Divorces,  desertions,  and  social 
dissipations  result  in  a  vast  amount  of  human  worry,  sorrow, 
and  sickness.  Oftentimes  it  is  unnecessary  to  go  beyond  the 
domestic  circle  in  search  of  the  exciting  causes  of  the  emotional 
state  which  exhausts  the  nervous  vitality.  The  grief  which 
follows  a  break  in  the  family  through  death  or  marriage,  or 
the  anxiety  occasioned  by  the  precarious  health,  the  prolonged 
absence,  or  even  the  dissolute  habits,  of  one  of  its  members, 
is  frequently  enough  to  bring  some  other  member  low. 

Household  problems  are  another  cause  of  worry.  The  proper 
rearing  of  the  boy,  the  successful  training  of  the  girl,  the  usual 
petty  cares  of  the  home,  to  which  all  women  are  subject,  to- 
gether with  the  modern  servant  problem  —  all  serve  to  create 
anxiety  and  worry,  together  with  the  useless  and  unnecessary 
toil  connected  with  the  family  life.  Many  housewives  are  con- 
stantly worried  over  the  proper  performance  of  little  things 
that  would  in  no  way  affect  the  family  happiness  if  they  were 
left  undone. 

Many  a  mother,  when  she  wakes  up  in  the  morning,  begins 
the  day  in  a  state  of  anxious  and  nervous  agitation;  she  feels 
herself  already  crushed  under  the  weight  of  all  the  burdens  she 
will   have   to  bear.     The   little   household   cares   and   domestic 


t  AUSES  OF  n'OKKl'  7$ 

rials  which  every  mother  experiences  are  not  to  her  simple 
mnoyances;  they  are  actual  catastrophes,  and  she  suffers  every 
me  of  these  calamities  a  score  of  times  before  it  comes.  By 
loon  her  life  is  swarming  with  apprehensions,  difficulties,  and 
roubles,  worry  reigns  supreme  on  the  throne  of  her  mind,  and 
iistraction  has  come  to  possess  her  soul.  At  the  close  of  the 
lay  this  unhappy  mother  has  borne  a  hundred  sorrows  which 
vere  wholly  imaginary,  produced  entirely  by  abnormal  and  un- 
:ontrolled  emotion. 

Among  social  causes  of  worry  are  those  of  jealousy  and  dis- 
rust,  the  social  rivalry  and  ambition  found  among  the  "  smart 
;et  "  of  our  metropolitan  centers.  Undue  sympathy  for  friends 
nay  be  set  down  as  another  cause  of  mental  uneasiness. 

Social  and  family  friction  may  cause  worry  to  the  point  of 
jroducing  such  high  blood-pressure  as  to  lead  its  victims  to 
:he  use  of  alcohol,  in  an  effort  to  secure  relief  from  mental 
md  nervous  tension.  Intemperance  may  be  set  down  as  both 
1  cause  and  a  result  of  worry. 

INDUSTRIAL    CAUSES    OF    WORRY 

Every  product  of  modern  inventive  genius  which  tends  to  de- 
crease the  physical  work  of  the  body  is  bound  to  increase  the 
tendency  toward  worry.  The  less  we  use  the  body,  the  more 
likely  we  are  to  overuse  (abuse)  the  mind. 

An  inordinate  worldly  ambition  may  generate  worry  on  the 
one  hand,  while  there  can  be  no  denying  the  fact  that  poverty 
is  a  provoker  of  worry  on  the  other  hand.  Financial  dif- 
ficulties and  business  reverses  must  be  set  down  as  among 
the  industrial  causes  of  an  uneasy  mind.  Industrial  disputes 
and  labor  difficulties,  the  constant  friction  between  combina- 
tions of  money  and  those  of  muscle,  produce  conditions  which 
are  ever  provocative  of  industrial  uncertainty,  and  therefore 
result  in  generating  mental  anxiety  and  worry. 

Accidents  incident  to  our  modern  industrial  life  produce 
worry  both  in  those  who  fear  them  and  those  who  are  compelled 
to  suffer  because  of  them;  in  fact,  the  complexity  of  the  de- 
mands of  our  modern  social  and  industrial  organization  is  such 
as  constantly  to  entoil  us  in  the  meshes  of  anxiety  and  worry. 


76  WORRY  AND  NERVOUSNESS 

PERVERTED  PROVERBS 

Many  a  good  old  saying,  proverbial  for  its  truthfulness  when 
properly  understood,  has  destroyed  the  peace  and  happiness 
of  those  who  have  come  to  worry  over  its  too  literal  fulfillment. 
Take  such  a  proverb  as  "  Look  before  you  leap."  This  old 
saying  certainly  contains  good  advice;  but  we  have  known  a 
number  of  earnest  men  and  women  who  have  long  remained 
stationary  in  their  life  plans,  looking  with  such  care  and  scru- 
tiny over  the  present  and  the  future,  that  they  have  failed  to 
take  advance  steps;  they  have  been  altogether  too  fearful  to 
leap;  they  would  not  dare  take  a  chance,  they  were  afraid 
of  the  risk.  Old  age  is  creeping  upon  them,  and  their  careers 
have  been  ruined  by  a  too  literal  interpretation  and  over-regard 
for  such  a  good  proverb  as  "  Look  before  you  leap." 

Another  of  the  old  proverbs,  responsible  for  causing  much 
worry,  is  the  oft-repeated  saying,  "  What  is  worth  doing  at  all 
is  worth  doing  well."  While  this  proverb  contains  sound  and 
wholesome  advice  for  every  young  man  and  woman,  it  must 
also  be  remembered  that  every  day  of  our  lives  we  are  called 
upon  to  perform  a  large  number  of  wholly  unessential  tasks, 
tasks  which  are  but  temporary  scaffolding,  as  it  were,  com- 
pared to  the  more  important  character-structure  we  are  build- 
ing. It  is  true  that  these  minor  tasks  must  be  done  with  suf- 
ficient care  so  as  not  to  endanger  the  real  structure  we  are 
erecting;  nevertheless,  it  would  be  a  great  waste  of  energy  to 
try  carefully  to  square,  polish,  and  paint  the  scaffolding  which 
stands  but  today  and  tomorrow  is  torn  away. 

And  this  is  true  of  much  of  our  common  work.  Each  day's 
efforts  should  be  wisely  divided  up  into  the  essential  and  the 
unessential ;  and  as  we  review  the  events  of  the  day  in  its  clos- 
ing hours,  it  should  be  no  occasion  for  worry  and  self-reproach 
that  some  trifle  has  had  to  be  slighted  or  altogether  neglected. 
If  the  brick  and  mortar  you  have  put  into  the  real  character 
structure  are  sound  and  good,  if  your  wall  has  been  raised  up 
true  to  the  plumb,  let  not  the  miscarriage  of  some  detail  either 
distress  or  worry  you. 

Many    conscientious   young   people   have   worried   altogether 


CAUSES  OF  WORRY  77 

too  much  over  such  teaching  as,  "  Be  sure  you  are  right,  then 
go  ahead."  Owing  to  their  peculiar  mental  make-up,  their  nat- 
urally diffident  and  hesitating  disposition,  they  could  never  be 
quite  sure  that  they  were  absolutely  right;  and  so  they  never 
went  ahead.  For  years  they  remain  stationary  in  their  life 
plans,  first  contemplating  one  thing,  then  another,  and  then 
pretty  soon  they  begin  seriously  to  worry  because  they  have 
not  gone  ahead. 

"Haste  makes  waste"  is  usually  found  to  be  true;  but  there 
are  times  in  life  when  it  is  absolutely  necessary  that  one  should 
make  haste ;  when  decisions  must  be  quickly  formed  and  speed- 
ily executed;  delay  would  be  fatal.  Now,  if  in  the  sober  after 
moments  it  should  develop  that  the  highest  wisdom  had  not 
characterized  the  formation  of  these  hasty  conclusions,  it  should 
be  no  cause  for  life-long  worry  and  everlasting  regret.  Per- 
haps no  one  else  could  have  done  better  under  the  circumstances ; 
after  all,  you  did  the  best  you  could.  If  there  is  anything  to 
learn  from  your  apparent  mistakes,  learn  it  cheerfully,  and  then 
let  the  matter  forever  rest. 

And  so  we  see  that  the  misunderstanding  and  misinterpre- 
tation of  even  good  and  true  teaching  may  lead  to  such  a  one- 
sided and  extreme  regard  for  truth  and  duty  as  to  create  a 
condition  of  mental  uneasiness  and  dissatisfaction,  eventually 
leading  to  chronic  worry,  with  all  its  evil  effects  upon  mind, 
soul,  and  body. 

SUMMARY    OF    THE    CHAPTER 

1.  Strenuous  living  is  not  alone  to  blame  for  worry  and  nerv- 
ousness. Other  factors  are  —  hereditary  predisposition,  lack  of 
mind  control,  and  accidental  stress  or  strain. 

2.  Childhood  fears  and  early  emotional  disturbances  are  fre- 
quently at  the  bottom  of  later  nervous  manifestations.  The  early 
use  of  tea,  coffee,  and  other  narcotics  is  also  responsible  for 
worry  and  nervousness. 

3.  The  fears,  emotions,  and  indiscretions  of  the  adolescent 
youth  not  infrequently  lay  the  foundations  for  life-long  worry, 
nervousness,  and  semi-invalidism. 

4.  Nervous  stability  is  undermined  by  ignorance  of  sex 
hygiene,  misunderstanding  of  adolescent  phenomena,  and  by  the 
use  of  stimulants,  together  with  the  strain  of  social  activities. 

5.  Sensation,  fear,  and  focalized  attention  are  the  elements 


7n  WORRY  AND  NERVOUSNESS 

entering  into  the  formation  of  the  wicked  and  destructive 
"  worry  circle,"  by  which  means  anxiety  is  perpetuated  and 
chronic  worry  tends  ever  to  grow  worse  and  worse,  fed  by  the 
very  elements  of  its  own  creation. 

6.  Exaggerated  and  excessive  self-consciousness  is  a  common 
cause  of  worry.  An  imaginary  worry  may  be  unreal,  but  a 
worried  imagination  is  the  realest  thing  in  the  world. 

7.  We  must  strike  an  intelligent  balance  between  too  much 
work  on  one  hand,  and  the  friction  attendant  thereon ;  and  on  the 
other  hand,  too  much  rest  and  the  rust  of  character  which  is  sure 
to  follow. 

8.  Mental  work  never  kills.  Mental  work  plus  worry  is  highly 
injurious;  while  mental  work  plus  worry  plus  insomnia  repre- 
sents a  combination  which  will  quickly  destroy  the  health  of 
mind  and  body. 

9.  In  the  last  analysis,  the  most  important  factor  in  the  direct 
causation  of  nervous  breakdown  is  the  emotional  life  of  the  indi- 
vidual —  the  mind  control  —  or  lack  of  control. 

10.  Thousands  of  souls  are  held  in  perpetual  bondage  by  imag- 
inary fetters.  They  are  victims  of  a  "  spirit  of  infirmity."  A 
ili>couraged  and  downcast  mental  attitude  may  so  habitually  bow 
down  the  body  as  to  produce  permanent  physical  deformity. 

11.  When  tempted  to  borrow  trouble,  when  harassed  by  ficti- 
tious worries,  remember  the  old  man  who  had  passed  through 
"  many  troubles  —  most  of  which  never  happened." 

12.  The  moral  habits  and  spiritual  state  not  infrequently  con- 
tribute much  toward  the  production  of  worry.  Religion  may  be 
either  a  cause  or  a  cure  of  worry.  As  the  old-fashioned  religion 
declines,  worry  seems  to  increase.  Religious  fanaticism  is 
undoubtedly  a  cause  for  worry  and  nervousness. 

13.  Physical  weakness,  bodily  deformity,  and  numerous  dis- 
eases all  figure  as  causes  of  worry.  Xine-tenths  of  ordinary 
non-contagious  diseases  originate  in  the  mind  as  a  result  of 
worrv.  Every  age  has  its  peculiar  worries :  there  are  childhood 
worries,  as  well  as  old  age  worries. 

14.  Some  new  f angled  health  fad  may  set  the  whole  country 
worrying  about  indigestion  and  dyspepsia.  Magazine  articles 
and  health  books  are  often  able  to  give  their  nervous  readers  an 
entirely  new  set  of  imaginary  diseases.  • 

15.  Common  physical  ailments  which  may  be  traced  to  worry 
are  insomnia,  loss  of  weight,  anaemia,  rise  of  blood-pressure, 
hardening  of  the  arteries,  premature  old  age,  apoplexy,  head- 
ache, dyspepsia,  constipation,  poor  circulation,  and  predisposi- 
tion to  catching  disease. 

16.  Among  the  social  causes  of  worry  may  be  mentioned 
divorces,   family  cares,  household  problems,  and  servant   diffi- 


CAUSES  OF  WORRY 

:ultics ;  as  well  as  business  difficulties,  industrial  disputes,  and 
abor  troubles. 

17.  M  Look  before  you  leap,"  and  numerous  other  good  prov- 
erbs may  be  so  perverted  as  to  lead  to  much  worry  and  inaction. 
Dther  proverbs  commonly  perverted  are,  "  What  is  worth  doing 
it  all  is  worth  doing  well :  "  and,  "  Be  sure  you  are  right,  then  go 
ihead." 

18.  Each  day's  efforts  should  be  wisely  divided  into  the  essen- 
tia] and  the  non-essential ;  and  it  should  be  no  occasion  for  worry 
if  some  trifle  has  been  slighted  or  neglected,  as  we  review  the 
events  of  the  day. 


CHAPTER  VII 
HABIT  TENSION  OF  MIND  AND   BODY 

THE  study  of  physiology  and  psychology  disclose  the  vast 
possibilities  existing  in  the  human  body  and  brain  for 
the  origin  of  inaccuracies,  the  birth  of  deceptions,  the  creation 
of  delusions,  and  the  production  of  a  vast  system  of  baseless 
fears,  false  conceptions,  erroneous  conclusions,  and  nervous 
tensions.  This  systematized  mental  fear,  moral  cowardice,  and 
habit  tension  may  be  summed  up  in  the  one  word  —  superstition. 

ANCIENT     HEALTH     DELUSIONS 

From  time  immemorial,  relics  have  been  associated  with  health 
and  disease.  The  bodies  of  either  dead  or  living  saints  were 
supposed  to  be  life-giving  and  healing  to  the  touch  —  even  to 
touch  the  tombs  of  some  of  the  saints  was  reputed  to  cure  one's 
disease.  Superstition  has  long  since  become  almost  a  habit 
with  many  people. 

A  decoction  made  of  a  piece  of  the  tombstone  of  a  good 
man  was  supposed  to  cure  malignant  disease  when  everything 
else  had  failed.  For  some  diseases,  it  was  a  sure  cure  to  lick 
the  tombstone  of  a  saint.  To  kiss  the  temple  floors  whereon 
saints  had  trod  was  also  supposed  to  confer  extraordinary  heal- 
ing power. 

Many  of  these  relic  delusions  were  systematically  practised 
right  up  to  the  eighteenth  century,  and  today  we  frequently 
read  of  pilgrimages  and  excursions  to  the  relics  and  shrines  of 
the  saints,  where  scores  of  people  are  reputed  to  have  been 
instantly  healed  of  their  diseases.  The  relic  superstition  has 
not  entirely  disappeared. 

SUPERSTITION  AND  NERVOUS  DISORDERS 

The  superstition  of  the  ancients  respecting  the  insane  led 
to  the  most  unfortunate  and  inhuman  treatment  of  these  mental 

80 


HABIT  TENSION  OF  MIND  AND  BODY  81 

sufferers.  The  insane  of  past  ages  were  the  most  maltreated 
of  all  the  afflicted.  The  idea  that  mental  diseases  and  insanity 
were  directly  attributable  to  demoniacal  possession  resulted  in 
producing  such  a  prejudice  against  the  mentally  unbalanced 
of  olden  times  that  they  received  but  little  or  no  sympathy  and 
care  from  their  fellow  men. 

Another  idea  respecting  insanity  was  that  some  forms  of 
mental  derangement  came  from  allowing  the  moon  to  shine 
directly  upon  the  face.  Indeed,  it  was  this  belief  that  gave 
origin  to  the  name  lunacy —  from  Luna,  the  moon.  In  the  good 
old  days,  mental  patients  would  have  some  superstitious  remedy 
tried  on  them,  and  if  they  made  no  immediate  improvement, 
they  were  cast  out  from  civilization  as  victims  of  lunacy,  or 
else  they  were  regarded  as  having  become  possessed  of  devils. 
At  a  later  date,  lunatics  were  sometimes  confined  in  what  were 
known  as  "  fool  towers  "  and  still  later  they  were  incarcerated 
in  the  "  witch  towers."  It  is  certainly  a  cause  for  universal 
rejoicing  and  gratitude  that  in  the  case  of  these  mental  suf- 
ferers, the  superstitions  of  the  dark  ages  no  longer  guide  so- 
ciety in  its  treatment  of  the  insane  and  the  mentally  unbalanced. 
At  the  present  time,  in  most  parts  of  the  United  States,  the 
mental  patients  confined  in  state  institutions  receive  thorough- 
going up-to-date,  and  scientific  treatment  for  their  mental 
maladies.  In  recent  years,  medical  superstition  seems  to  have 
crystalized  itself  into  numerous  modern  "  mind  cures "  and 
"  faith-healing  "  cults. 

THE  PHYSIOLOGY  OF  HABIT 

The  physiology  of  habit  is  explained  by  reference  to  the 
nervous  reflex  arc,  by  which  means  certain  sensory  nervous 
impressions  are  carried  to  the  various  nerve  centers,  where, 
after  a  time,  they  come  spontaneously  and  automatically  to 
produce  certain  definite  motor  responses.  Nerve  paths,  as  it 
were,  are  worn  deeper  and  deeper,  and  this  causes  a  given 
habit  to  become  more  and  more  deeply  rooted.  Frequent  repeti- 
tion of  nervous  impulses  passing  over  the  same  path  serves  to 
wear  the  nervous  groove  deeper  and  deeper,  just  as  frequent 
walking  over  the  lawn  will  wear  a  deep  path  through  the  sod. 


82  WORRY  AND  NERVOUSNESS 

The  period  of  infancy  is  the  special  time  for  starting  or 
initiating  mental  and  physical  habits.  The  longer  the  infancy 
of  any  animal,  the  greater  the  range  and  possibility  for  the 
formation  of  numerous  habits  —  good  or  bad  —  which  will  prove 
either  of  great  help  or  hindrance  in  after  life.  It  is  evident  that 
not  all  of  our  habits  are  formed  in  infancy.  Habits  may  be 
formed  in  after  life;  but  the  older  the  learner,  the  more  diffi- 
cult it  is  either  to  form  or  reform  a  habit.  All  our  established 
habits  form  actual  and  literal  pathways  through  the  nervous 
mechanism  of  the  body.  Habits  have  a  material  foundation, 
and  no  habit  when  once  thoroughly  established  can  be  changed 
without  effecting  a  change  in  these  nerve  paths  through  the 
body,  as  a  result  of  placing  the  nerve  centers  concerned  under 
the  absolute  domination  of  an  ever-watchful  and  all-powerful 
new  idea. 

When  we  yield  willingly  and  readily  to  the  impulse  to  do  a 
certain  thing,  the  next  time  that  same  impulse  is  experienced 
the  responsive  action  of  the  body  will  be  just  a  little  more 
quickly  and  easily  performed.  This  frequent  repetition  estab- 
lishes what  the  physiologists  call  the  "  path  of  motor  dis- 
charge "  ;  and  when  a  nervous  path  becomes  well  established, 
we  have  laid  the  foundation  for  a  new  habit.  This  constitutes 
the  physiological  explanation  of  habit. 

It  is  highly  probable  that  in  the  early  formation  of  habits,  the 
discharge  of  motor  impulses  excited  by  sensory  impressions 
follows  the  path  of  least  resistance.  Just  as  the  small  stream- 
lets from  a  cake  of  melting  ice  make  their  way  toward  lower 
levels  in  obedience  to  the  law  of  liquids,  wearing  a  larger  and 
larger  groove  as  the  volume  of  water  increases,  converting 
obstructions  and  obstacles  into  high  retaining  walls;  so,  event- 
ually, the  stream  of  nervous  energy  is  compelled  to  flow  in 
the  deep  and  permanent  grooves  formed  by  its  own  long-con- 
tinued action. 

THE  PSYCHOLOGY  OF  HABIT 

Just  £8  various  groups  of  nerve  cells  in  the  spinal  column 
and  the  lower  nerve  centers  get  into  the  way  of  working  to- 
gether  (form  habits  of  cooperation,  in  other  words),  so  in  the 


HABIT  TEXSIOX  OF  MIND  AND  BODY  83 

case  of  the  nerve  cells  in  the  higher  brain  centers.  Various 
sensory  and  conscious  nerve  impressions  come  to  be  definitely 
associated,  sooner  or  later,  with  the  activity  of  certain  definite 
groups  of  motor  brain  cells.  Certain  associated  feelings  and 
ideas  are  aroused  by  a  given  impulse,  and  by  the  repetition  of 
this  connection  a  mental  habit  is  formed,  which  gradually  wears 
down  for  itself  definite  material  grooves  in  the  paths  of  the 
brain. 

The  machinery  of  thought  rapidly  settles  into  the  ruts  and 
grooves  of  its  own  formation.  These  psychic  channels  are 
formed  in  the  early  periods  of  life,  and  it  is  quite  likely  that 
they  are  largely  established  by  the  time  a  man  reaches  thirty- 
years  of  age.  Xot  that  new  channels  of  thought  cannot  be 
formed,  and  new  associations  of  ideas  affected:  but.  after  this 
age.  the  mind  forms  new  methods  of  thought  and  action  with 
great  difficulty,  and  only  in  response  to  definite  mental  training 
and  continuous  intellectual  activity. 

Our  psychic  habits  are  formed  also  by  the  care  or  attention 
we  pay  to  the  constant  stream  of  sensations  which  have  their 
origin  in  all  parts  of  the  body,  in  sense  impressions  which  never 
cease  to  recur  as  long  as  life  lasts.  Ordinarily,  the  vast  major- 
ity of  these  impressions  do  not  arouse  sensations  at  all.  Nor- 
mally, furthermore,  the  majority  of  sensations  so  awakened 
have  at  most  but  a  fleeting  or  momentary  claim  upon  our  atten- 
tion. Those  unfortunates  who  develop  the  habit  of  recognizing 
all  these  sensory  reports  from  the  outlying  physical  domains  of 
the  body,  soon  degenerate  into  confirmed  neurasthenics.  The 
old  lady  was  not  far  from  right  when  she  advised  the  nervous 
young  girl  to  keep  her  "  mind  off  your  thoughts."' 

THE    TYRANNY    OF    HABIT 

It  must  be  evident  that  the  formation  of  habits  is  a  source  of 
great  economy  to  both  mind  and  body.  It  should  be  also 
recognized  that  when  habits  are  misformed,  when  mind  and 
body  are  trained  in  unfortunate  and  unhealthy  modes  of  thought 
and  action,  that  the  results  upon  the  health,  happiness,  and 
character  may  ba  highly  disastrous. 

Habit    is    a    sort    of    partnership    arrangement    entered    into 


84  WORRY  AND  NERVOUSNESS 

between  the  mind  and  the  body  for  the  purpose  of  accomplishing 
a  maximum  amount  of  work  with  a  minimum  expenditure  of 
mental  energy  and  physical  force.  If  habits  are  well  formed, 
intelligently  shaped,  and  properly  controlled,  they  become  the 
great  secret  of  mental  conservation  and  a  source  of  great  phys- 
ical economy;  on  the  other  hand,  if  habits  are  misformed  —  if 
they  are  injurious  to  mind  and  body  —  after  they  once  become 
thoroughly  established,  they  may  enslave  and  rule  their  sub- 
ject with  absolute  tyranny. 

When  we  recognize  that  it  is  just  as  easy  to  form  a  good  habit 
as  a  bad  habit,  just  as  easy  to  acquire  helpful  habits  as  those 
which  are  injurious,  it  becomes  apparent  that  a  great  responsi- 
bility rests  upon  parents  and  teachers  to  see  to  it  that  the  chil- 
dren under  their  care  early  form  correct  and  proper  habits  of 
thinking  and  acting. 

THE    SLAVERY    OF    NERVOUS    TENSION 

By  nervous  tension  or  obsession  we  refer  to  those  constantly 
recurring  ideas,  feelings,  or  emotions  which  present  themselves 
so  insistently  and  automatically  in  our  consciousness,  and  which 
always  lead  to  the  performance  of  certain  useless  actions  or  the 
thinking  of  certain  foolish  thoughts.  These  needless  acts  and 
thoughts  are  oftimes  injurious  to  peace  of  mind  and  health  of 
body.  Our  obsessions  are  not  useful,  and  they  are  otherwise 
inharmonious  with  our  useful  mental  experience  and  modes  of 
acting;  they  are  troublesome  interlopers  which  have  chosen  our 
minds  and  bodies  as  their  regular  playground;  their  conduct 
results  in  constantly  interfering  with  the  normal  work  of  both 
mind  and  body.  Mental  obsessions  are  probably  due  to  a  mild 
form  of  dissociation  of  ideas,  while  bodily  obsessions  are  estab- 
lished after  the  usual  methods  of  habit  formation. 

Psychic  obsessions  are  very  common.  The  inconsistent  notion 
that  one  must  always  be  right  has  spoiled  the  health  and  ruined 
the  happiness  of  thousands  of  people.  This  desire  is  born  of 
an  unhealthful  tendency  to  want  our  way  to  become  the  pattern, 
after  which  all  others  must  shape  their  conduct.  This  leads  to 
an  everlasting  wrangle  with  one's  associates,  in  which  the  victim 
of  this  obsession  is  ever  contending  that  he  is  right  and  all  the 


HABIT  TENSION  OF  MIXD  AXD  BODY  85 

world  is  wrong.  It  would  add  much  to  the  happiness  and  health 
of  some  of  these  obstinate  contenders  for  their  own  personal 
infallibility  if  they  would  come  down  from  their  high  perch  of 
perfection,  confess  their  humanity,  admit  their  blunders  — 
actually  *'  acknowledge  the  corn  "  now  and  then.  The  world 
is  filled  with  unhappy  and  irritable  people  who  have  never  been 
known  to  confess  to  having  made  a  mistake  or  done  wrong  in  all 
their  lives. 

Others  live  in  constant  slavery  to  fashion,  to  the  fear  of  man, 
and  the  conventional  way  of  doing  things.  The  author  has  a 
dear  friend  who  is  simply  killing  himself  with  the  obsession  that 
he  must  carry  through  everything  that  he  undertakes  —  at  any 
cost.  His  life  is  devoted  to  "carrying  things  through"  —  to 
patching  up  his  evident  blunders  and  trying  to  make  successful 
his  repeated  failures. 

Others  are  obsessed  with  the  insane  notion  that  they  must  set 
other  people  right  —  the  notion  of  reforming  the  world.  These 
people  live  in  a  constant  state  of  worry  and  irritation  because 
their  petty  hobbies  do  not  gain  the  recognition  which  they  think 
their  schemes  deserve. 

Certain  sensitive  and  self-centered  nervous  people  get  the 
notion  into  their  heads  that  they  are  being  terribly  persecuted; 
they  fancy  themselves  living  a  life  of  perpetual  martyrdom. 
They  are  victims  of  constant  imaginary  sufferings  and  fictitious 
slights.  It  would  seem  that  some  of  them  really  learn  to  love 
this  life  of  the  false  martyr. 

We  are  acquainted  with  a  man  who  has  made  life  unbearable 
for  himself  and  family  because  of  his  ever-present  obsessing 
ideas  that  he  must  accept  no  favors,  allow  no  one  to  assist  him. 
be  under  obligations  to  nobody ;  and  these  ideas  have  brought 
him  almost  to  the  verge  of  a  form  of  insanity,  so  that  he  is 
persona  non  grata  in  all  circles. 

Dr.  Sidis  tells  of  a  man  who  would  never  board  a  car  with 
an  odd  number.  Psychoanalysis  disclosed  the  fact  that  he  had 
once  seen  a  child  run  down  and  seriously  injured  by  an  odd- 
numbered  car.  Never  since  witnessing  this  accident  did  he 
permit  himself  to  board  an  odd  numbered  car. 


86  WORRY  AND  NERVOUSNESS 

COMMON    MOTOR   OBSESSIONS 

This  form  of  slavish  worry  has  succeeded  in  fastening  itself 
on  the  nervous  system  and  the  daily  behavior  of  most  of  us  in 
some  form  or  other.  It  is  shown  in  the  case  of  the  small  boy, 
who,  while  going  downtown  on  an  errand  for  his  mother,  easily 
forgets  what  he  was  sent  for,  but  in  no  wise  forgets  to  kick 
every  hitching-post  he  meets  on  the  way  down  town.  Even  some 
adults  cannot  pass  a  post  without  touching  it.  It  is  likewise 
shown  in  the  case  of  the  woman  who  tries  to  keep  from  stepping 
on  the  cracks  or  seams  of  the  sidewalk  on  her  way  down  street. 

The  awkward  uneven  steps  of  such  an  individual  sometimes 
are  sufficient  to  attract  the  attention  of  the  passers-by.  The 
author  once  followed  a  young  lady  for  fourteen  blocks  and 
observed  that  this  obsessed  soul  did  not  once  permit  her  shoes 
to  fall  upon  a  seam  in  the  cement  walk. 

Have  you  not  known  the  man  who  could  not  put  his  hand 
in  his  pocket  without  continuously  counting  the  pieces  of 
money  contained  therein?  A  patient  recently  told  the  author 
that  he  could  not  enjoy  a  stroll  unless  he  had  a  bunch  of  money 
to  count  in  his  right-hand  trousers'  pocket;  that  if  he  did  not 
have  any  loose  change  when  he  went  out  for  a  walk,  he  would 
have  to  go  and  get  some;  that  he  knew  just  how  many  pieces 
of  money  the  pocket  contained,  and,  if  on  any  single  count,  he 
failed  to  find  the  right  number,  he  would  often  have  to  stop  dead 
still  and  carefully  recount  the  coins  to  make  sure  that  none  had 
been  lost ;  after  which  he  could  resume  his  walk. 

Another  case  of  obsession  is  that  of  the  person  who  cannot 
sit  in  a  public  auditorium  or  church  without  counting  the  number 
of  rings,  roses,  or  stripes  on  the  wall-paper,  usually  trying  to 
settle  on  the  center  one  and  then  to  watch  it  with  an  eagle  eye. 
If  for  any  reason  the  attention  is  distracted  from  this  center 
figure  and  it  is  momentarily  lost  to  view,  the  whole  number  of 
designs  must  be  counted  over  again  and  the  center  carefully 
located. 

After  speaking  of  this  matter  in  a  Chautauqua  lecture  one 
afternoon,  an  intelligent  looking  lady  told  us  she  had  counted 
every  seam  in  the  tent,  knew  the  middle  seams,  and  likewise  had 
counted  the  stripes  of  all  the  other  tents  on  the  grounds.     She 


HABIT  TENSION  OF  MIND  AND  BODY  87 

said  that  this  was  her  favorite  pastime  —  to  count  the  stripes, 
figures,  and  other  objects;  if  nothing  else  presented  itself,  she 
would  count  the  pickets  on  the  fence. 

We  once  had  a  patient,  a  young  man,  who,  when  not  otherwise 
employed,  would  hie  himself  to  the  railroad  and  watch  for  the 
numbers  on  the  freight  cars,  taking  great  delight  when  he 
would  see  a  number  which  he  could  recall  having  seen  some- 
time previous. 

A  woman  school  teacher  of  middle  age  once  consulted  the 
author  to  see  what  help  she  could  get  for  her  obsession  —  of 
everlastingly  counting  her  steps.  She  said  it  was  nineteen  steps 
from  her  front  porch  to  the  gate ;  that  it  was  555  steps  from  her 
house  to  the  grocery ;  that  the  court  house  had  twenty-one  steps 
going  up  the  first  flight,  etc.,  etc.  She  said  she  made  the  trip 
from  the  house  to  the  gate  one  day  in  one  step  short  of  the 
usual  count,  and  was  so  disturbed  that  she  had  to  go  back  to  the 
house  and  walk  the  distance  over  again,  that  she  might  walk  it 
in  the  usual  number  of  steps.  Others  are  possessed  of  obsessions 
born  of  their  physical  appearance,  or  determined  by  their  undue 
tendency  toward  being  too  fat  or  too  lean.  Another  very  com- 
mon obsession  is  the  habitual  twirling  of  the  thumbs  while  the 
fingers  are  interlocked. 

Moll  calls  attention  to  the  fact  that  the  imperative  concepts, 
obsessions,  such,  for  instance,  as  the  fear  of  open  spaces 
(agoraphobia),  owe  their  origin  to  auto-suggestion.  The 
agoraphobic  patient  becomes  dominated  by  the  idea  that  he 
cannot  traverse  an  open  space,  his  own  will  is  too  weak  to 
withstand  this  autosuggestion,  and  every  attempt  to  traverse 
an  open  space  brings  forth  the  typical  feeling  of  fear. 

STILL    OTHER    OBSESSIONS 

It  is  indeed  surprising  to  see  how  many  otherwise  sensible 
people  are  led  into  fears  and  worry  by  these  common  insistent 
ideas  and  impulses.  They  get  into  the  notion  that  their  spelling 
is  wrong  or  that  stray  hairs  or  particles  of  lint  are  sticking  to 
their  clothes.  Or  perhaps  it  is  in  the  motor  sphere,  and  then 
the  ideas  take  the  form  of  imperative  impulses  or  forced  acts, 
such  as  smashing  things  or  boxing  people's  ears.     If  it  is  the 


W 


88  WORRY  AXD  NERVOUSNESS 

feelings  that  are  affected,  especially  feelings  of  anxiety,  then 
we  speak  of  phobias,  such  as  fear  of  an  empty  room,  fear  of 
place-,  spiders,  mice,  etc. 

For  the  more  general,  less  morbid  desires  or  dislikes  of  indi- 
viduals with  reference  to  particular  things  we  use  the  term 
idiosyncrasies.  Forel  says:  "I  saw  a  girl  whose  life  was  a 
burden  because  she  could  never  see  a  doll  without  becoming 
fearfully  afraid  it  would  cry;  that  she  would  run  away  as  from 
the  devil  incarnate."  Many  people  remain  continually  under 
the  influence  of  a  strongly-marked  and  exaggerated  mood,  which 
rests  on  a  diseased  disposition  and  is  abnormal  because  it  is  for 
the  most  part  without  any  real  physical  foundation.  The  moods 
include  sadness  and  melancholy,  sensitiveness,  hate,  jealousy, 
suspicion,  or,  on  the  other  side,  good  spirits  and  mirthfulness 
or  a  form  of  heedless  optimism. 

Some  neurotic  subjects  have  a  wonderful  faculty  of  crystal- 
izing  their  fears  and  dreads.  They  seem  to  be  a  veritable  Pan- 
dora box  of  phobias.  They  live  in  constant  terror  of  thunder 
storms,  high  places,  drinking  water,  animals,  mad  dogs,  torna- 
does, etc.,  etc. 

VITAL    SEEPAGE  —  ENERGY    LEAKAGE 

The  world  is  filled  with  nervous,  fidgety  persons  who,  while 
they  are  probably  not  victims  of  definite  mental  or  motor  obses- 
sions, are  constantly  engaged  in  numerous  physical  activities 
which  are  wholly  useless  and  unnecessary.  Every  such  useless 
act  constitutes  a  needless  drain  on  the  nervous  system. 

Such  slaves  of  habit  cannot  sit  down  without  crossing  their 
legs  and  tossing  the  foot,  or  tapping  the  foot  on  the  floor.  Some 
part  of  their  anatomy  must  be  in  rhythmical  and  incessant  action. 
Others  will  twist  their  moustaches  or  play  with  their  hair.  We 
are  acquainted  with  a  professional  man  who  cannot  sit  down  a 
moment  without  starting  up  a  drumming  with  his  feet  on  the 
floor,  or  else  he  will  beat  an  incessant  tattoo  with  his  hands  on 
the  chair.  Others  are  everlastingly  fixing  their  clothes  or 
adjusting  the  necktie;  they  seem  never  to  be  able  to  complete 
their  toilet.  All  these  needless  and  useless  maneuverings  con- 
stitute a  tremendous  nervous  and  vital  drain  on  the  victim's  con- 


HABIT  TENSION  OF  MIND  AND  BOD)'  89 

stitution.  It  is  a  sort  of  vital  seepage  —  there  is  a  constant 
leakage  of  nervous  force  and  muscular  energy. 

We  know  a  young  business  man  who  is  constantly  clearing  his 
throat.  We  have  a  patient  who  engages  in  incessant  coughing  — 
purely  nervous  coughing.  Numerous  cases  of  nervous  break- 
down from  worry  are  due  to  just  this  sort  of  nervous  ex- 
travagance plus  incessant  brooding  and  perpetual  worry.  Xo 
constitution  can  long  stand  to  be  drained  by  worry,  other  vital 
leakage,  and  obsessions.  Sooner  or  later,  the  strongest  nervous 
system  will  be  undermined,  the  vitality  of  the  sufferer  effec- 
tively sapped,  and  the  resultant  catastrophe  strikes ;  there  occurs 
either  a  blow-up  or  a  breakdown. 

"  Sidetrackability  "  is  the  name  which  some  one  has  given  to 
the  condition  of  those  nervous,  erratic  people  whose  energies 
are  being  diverted  from  a  legitimate  and  natural  source  into  ab- 
normal and  harmful  channels. 

>Y.-TEM     AND    ORDER 

Many  persons  would  improve  their  peace  of  mind  and  health 
of  body  if  they  would  learn  to  be  systematic  and  orderly  in  the 
details  of  their  everyday  life.  To  look  at  the  desks  of  some 
business  men;  to  look  into  the  study  rooms  of  some  professional 
men,  to  go  through  the  homes  of  some  housewives,  is  enough  to 
explain  why  so  many  of  these  people  work  so  hard  and  accom- 
plish so  little.     Everything  is  in  disorder — no  system  prevails. 

It  is  highly  essential  that  intelligent  methods  and  automatic 
habits  should  be  formed  for  carrying  on  one's  regular  daily 
work;  on  the  other  hand,  it  is  altogether  possible  to  make  a 
veritable  obsession  out  of  law  and  order.  We  are  acquainted 
with  a  young  man  who  accomplishes  but  little  in  life  except  to 
keep  his  study  in  order.  So,  while  we  recommend  system  and 
order  as  a  means  of  economizing  time  and  energy,  we  do  not 
mean  that  they  should  be  carried  to  the  point  of  unbounded  fussi- 
ness  and  unbearable  neatness. 

Nevertheless,  it  is  a  fact  that,  by  making  as  much  of  our 
work  as  possible  automatic,  we  relieve  the  higher  controlling 
centers  of  the  brain  from  the  necessity  of  attending  to  these 
details,  and  in  this  way.  we  vastly  increase  the  opportunity  and 


9o  WORRY  AND  NERVOUSNESS 

power  of  the  mind  for  the  performance  of  additional  useful  and 
original  work. 

COOL-HEADEDNESS 

One  of  the  things  most  needed  in  our  modern  civilization  is 
cool-headedness,  the  power  to  think  more  than  once  while  in  the 
same  spot.  Thoughtlessness  is  responsible  for  many  of  our 
difficulties.  Some  unfortunate  souls  have  got  into  a  chronic 
habit  of  "  being  constantly  rushed."  It  makes"  no  difference 
where  or  when  you  meet  them,  they  are  "  simply  rushed  to 
death  ;  "  "  haven't  time  to  think ;  "  "  so  glad  to  see  you,  but  haven't 
time  to  talk  it  over  now;  "  etc.,  etc.  Why,  it  really  makes  you 
nervous  simply  to  meet  them  on  the  street.  They  seem  to  have 
a  sort  of  psychic  St.  Vitus'  dance. 

These  restless  people  are  like  a  steam  engine  with  the  governor 
off;  they  are  making  a  great  fuss,  a  big  noise,  but  they  are  ac- 
complishing but  little  in  the  line  of  real,  useful  work.  These 
chronically  rushed  folks  keep  both  mind  and  body  working  under 
a  terrible  strain,  until  by  and  by  this  state  of  strain  becomes 
habitual;  they  become  chronically  keyed  up;  they  cannot  let  go; 
they  cannot  relax.  Even  when  they  go  to  bed  at  night,  they 
are  still  so  rushed  that  they  are  often  unable  to  find  time  to  go 
to  sleep,  and  consequently  they  lie  awake  half  the  night. 

This  unnecessary  and  abnormal  rushing  through  life  is  proba- 
bly due  to  exaggerated  ideas  of  one's  importance,  or  else  it  must 
be  due  to  an  overestimation  of  the  importance  of  the  work  one 
is  doing.  Most  of  us  need  to  learn  to  take  ourselves  less  seri- 
ously, and  some  ought  to  learn  to  take  even  their  work  less 
seriously.  It  was  a  wise  mother  who  said  to  her  nervous  daugh- 
ter, "  My  child  you  cannot  possibly  exaggerate  the  unimportance 
of  things." 

ENVIRONMENTAL    NERVOUS    TENSION 

It  is  a  great  gift  to  know  how  to  get  along  with  one's  sur- 
roundings; how  to  react  to  the  changes  and  experiences  in  one's 
environment ;  how  calmly  to  accept  those  changes  which  cannot 
be  made  different;  how  to  be  a  successful  reformer,  and  yet  how 
to   keep    from    worrying   over    those    things   which    cannot   be 


HABIT  TENSION  OF  MIND  AND  BODY  91 

changed.  It  requires  strong  character  to  live  with  one's  asso- 
ciates and  yet  not  to  resent  their  incivilities  or  to  be  chafed  and 
exasperated  by  their  shortcomings.  It  is  a  good  plan,  "  when  in 
Rome,  to  do  as  Rome  does."  The  chameleon  is  a  fortunate  ani- 
mal ;  it  has  power  to  change  its  own  color  to  harmonize  with  the 
color  of  its  environment. 

A  certain  degree  of  muscular  rigidity  is  required,  when  one 
is  standing,  but  this  is  wholly  unnecessary  when  resting  in  a 
chair.  How  many  of  us  hold  ourselves  just  as  tight  in  the 
chair  as  if  we  were  holding  the  body  upright  while  walking. 
Why  should  a  carriage  ride  completely  exhaust  a  healthy  man? 
Simply  because  he  did  not  adjust  himself  harmoniously  to  the 
environment  of  the  drive,  he  did  not  fully  relax  and  enjoy  the 
ride.  All  the  while,  he  was  in  constant  fear  of  the  horse  run- 
ning away,  or  else  by  his  anxiety  and  tension  he  endeavored  to 
assist  the  horse  in  pulling  the  carriage,  instead  of  entering  into 
the  joys  and  pleasures  of  the  drive. 

When  riding  on  the  train,  we  should  become  as  one  with  the 
coach  and  be  carried  along  without  resistance,  by  the  engine, 
stopping,  starting,  and  otherwise  moving  in  perfect  harmony 
and  attune  with  the  train;  this  is  what  we  mean  by  harmonizing 
with  one's  environment ;  it  is  a  process  of  moving  through  life 
with  the  least  possible  friction  consistent  with  the  greatest  pos- 
sible mental  and  physical  action.  It  is  a  scheme  for  improving 
and  changing  every  remediable  and  objectionable  factor  in  our 
environment,  without  in  the  least  fretting  or  fuming  over  those 
conditions  which  we  cannot  change  or  remove. 

We  recently  rode  on  the  train  behind  a  high-strung,  tense, 
nervous  traveler,  who,  on  alighting  from  the  train,  exclaimed,  as 
she  fell  into  the  arms  of  a  waiting  friend,  "  Oh  !  Mary,  I  am 
just  all  worn  out,"  and  I  remarked  in  my  own  mind,  "  no  wonder, 
she  paid  two  cents  a  mile  to  ride,  and  then  she  helped  the  engine 
pull  the  train  every  mile  of  the  journey." 

THE    NERVOUS    RHYTHM    OF    HABIT 

We  should  constantly  bear  in  mind  that  habits  usually  estab- 
lish themselves  in  harmony  with  certain  laws  of  periodicity. 
There  is  a  tendency  toward  regularity  in  the  motor  discharge  of 


92  WORRY  AND  NERVOUSNESS 

our  established  habits,  whether  it  be  the  drumming  of  the  fingers 
on  the  table  or  the  regular  sprees  of  the  periodical  drunkard. 

We  get  the  habit  of  having  periodic  stimulation  —  that  is, 
periodically  whipping  our  nerves;  some  are  addicted  to  the  use 
of  alcohol  and  other  drugs,  still  others  make  use  of  tea  and 
coffee.  The  use  of  these  nerve  excitants  and  depressants  is  a 
confession  of  weakness  of  character  on  the  part  of  those  who 
depend  on  these  various  unnatural  and  harmful  methods  of 
exercising  the  nervous  system.  This  rhythmic  tendency  of 
nervous  impulses  is  an  important  factor  in  overcoming  bad 
habits  —  in  the  reeducation  of  the  nervous  system.  It  is  neces- 
sary that  all  formative  and  reformatory  efforts  should  be  sys- 
tematic and  regular;  every  effort  to  retrain  the  body  and  form 
new  habits  should  faithfully  be  carried  out  in  accordance  with 
this  law  of  nervous  periodicity. 

CAN   NERVOUS   HABITS   BE  CHANGED? 

Since  habits  possess  a  real  physical  foundation  and  an  actual 
psychologic  basis,  can  they  be  modified,  reshaped,  or  otherwise 
changed  after  their  slave  has  reached  maturity?  The  answer 
to  this  question  embraces  a  number  of  factors.  The  eradication 
of  the  old  habit  or  the  formation  of  the  new,  first  demands  the 
absolute  cooperation  of  the  will,  the  complete  making  up  of  one's 
mind  to  do  the  thing  in  question.  It  next  requires  that  the  body 
itself  shall  be  set  in  operation  in  the  desired  direction  of  forming 
the  new  habit.  New  thoughts  must  be  formulated  and  actually 
placed  in  command  of  the  mind.  The  new  actions  must  be 
executed  with  decision  and  regularity.  The  new  habit  must  be 
repeatedly  and  persistently  wrought  out  through  the  physical 
body. 

Persistent,  intelligent,  regular,  systematic,  and  determined 
effort  on  the  part  of  the  mind  will  prove  successful  in  uprooting 
almost  any  and  every  habit  which  can  fasten  itself  upon  the 
human  mind  or  body. 

SUMMARY    OF    THE    CHAPTER 

I.  Nervous  tension  is  akin  to  the  habits  of  superstition.  The 
mind  easily  falls  into  "  ruts  and  grooves,"  taking  the  path  of 
least  resistance. 


HABIT  TENSION  Of  MIND  AXD  BODY  93 

2.  Nervous  disorders  and  insanity  have  long  been  regarded 
with  amazing  superstition.  "  too\  towers"  and  "witchcraft" 
are  not  delusions  of  the  remote  past.  Only  recently  have  either 
"  nervousness  "  or  "  insanity  "  come  to  be  regarded  "  sanely." 

3.  Habit  is  a  sort  of  possible  economical  arrangement  or 
understanding  existing  between  the  mind  and  the  body  —  and  is 
capable  of  almost  unlimited  perversion  for  evil  when  not  rightly 
formed  and  intelligently  controlled. 

4.  The  period  of  infancy  is  the  special  time  for  initiating 
habits.  The  longer  the  infancy  of  an  animal,  the  greater  the 
range  and  possibilities  for  the  formation  of  habits. 

5.  Habits  are  due  to  actual  pathways  through  the  nervous 
mechanism  of  the  body.  Habits  have  a  material  foundation  as 
well  as  a  mental  basis. 

6.  Every  time  an  act  is  repeated  its  performance  becomes 
easier  and  easier;  the  "path  of  motor  discharge''  becomes 
increasingly  automatic  and  established. 

7.  Colonies  of  brain  cells  and  groups  of  ideas  (psychic 
centers)  come  also  to  form  definite  and  habitual  associations.  In 
this  way  mental  habits  are  formed,  habits  of  thought. 

8.  The  thinking  machinery  readily  settles  into  the  ruts  and 
grooves  of  its  own  formation.  After  thirty  years  of  age,  new 
habits  are  formed  only  as  the  result  of  persistent  psychic 
training. 

9.  Habit  is  a  sort  of  partnership  arrangement  between  the 
mind  and  the  body  for  the  purpose  of  accomplishing  a  maximum 
of  work  with  a  minimum  expenditure  of  energy. 

10.  It  is  just  as  easy  to  form  a  good  habit  as  a  bad  one.  When 
bad  habits  become  established,  they  rule  their  slave  with  abso- 
lute tyranny. 

11.  An  obsession  is  a  constantly  recurring  idea,  feeling,  or 
emotion,  which  presents  itself  incessantly  and  automatically  in 
our  experience,  and  which  leads  to  the  thinking  of  certain  foolish 
thoughts  and  the  performance  of  certain  useless  acts. 

12.  Mental  obsessions  are  probably  due  to  a  mild  form  of  idea- 
dissociation,  while  motor  obsessions  are  simply  habitual  acts 
resulting  from  automatic  and  uncontrolled  motor  discharges. 

13.  Common  obsessions  are  such  as  insistent  ideas,  counting, 
kicking  posts,  wiggling  the  toes,  twirling  the  thumbs,  twisting  the 
moustache,  drumming  on  the  chair,  or  tossing  the  foot  when  the 
legs  are  crossed. 

14.  Other  obsessions  are  fear  of  open  spaces,  distrust  of  one's 
spelling,  fear  of  hairs  on  the  clothing,  fear  of  empty  rooms, 
spiders,  mice.  etc. 

15.  These  obsessions  and  near-obsessions  constitute  a  tre- 
mendous   vital    drain    upon    the    constitution.     These    useless 


94 


WORRY  AND  NERVOUSNESS 


maneuvers   represent   a  species   of   vital   seepage  —  leakage   of 
nervous  force  and  muscular  energy. 

16.  Tossing  of  the  foot  when  the  legs  are  crossed;  tapping  on 
the  table  with  the  fingers  or  on  the  floor  with  the  foot,  together 
with  nervous  coughing,  etc.,  all  constitute  a  form  of  energy 
leakage. 

17.  System  and  order  in  doing  one's  daily  work  are  highly 
economical  and  helpful.  Automatic  action  conserves  the  time 
and  energy  of  the  higher  brain  centers.  It  is  possible  to  convert 
law  and  order  into  an  obsession,  so  that  instead  of  proving  a  help 
in  the  daily  affairs  of  life,  it  becomes  a  veritable  bondage. 

18.  The  habit  of  "  being  rushed  "  is  chronic  with  some  persons. 
It  is  an  extravagant  practice  —  wasteful  of  vital  energy.  Cool- 
headedness  would  help  numerous  people  out  of  many  of  their 
troubles. 

19.  A  common  form  of  habit  tension  is  seen  in  environmental 
resistance,  such  as  rigidity  while  riding  on  street  cars  and  rail- 
road trains.  Relaxation  is  synonymous  with  harmonizing  one's 
environment. 

20.  Habits  are  usually  formed  in  accordance  with  the  nervous 
laws  of  periodicity.  Motor  discharge  usually  follows  a  law  of 
regularity  when  it  becomes  habitual,  as  in  the  case  of  the 
periodical  drinker. 

21.  Persistent,  intelligent,  systematic,  and  determined  effort  on 
the  part  of  the  mind  will  usually  prove  successful  in  uprooting 
any  undesirable  habit  which  may  have  fastened  itself  on  mind  or 
body. 


CHAPTER  VIII 
CRYSTALIZED   FEAR   AND   DEFINITE   DREADS 

IN  A  general  way  we  have  dealt  with  the  long  established  fears 
and  other  obsessions  in  the  preceding  chapter.  In  this  chapter 
we  will  treat  of  those  special  crystalized  fears  and  certain  defi- 
nite phobias  or  dreads.  Phobia  is  the  Greek  word  meaning  fear, 
and  many  nervous  invalids  had  rather  have  their  crystalized 
fears  called  "  phobias  "  than  to  have  them  designated  in  plain 
English  as  definite  dreads. 

SPECIALIZED    PHOBIAS 

It  would  surprise  those  who  are  unfamiliar  with  the  fears  of 
nervous  patients,  to  know  how  many  otherwise  sanely  appearing 
individuals  are  afflicted  with  these  forms  of  specialized  fear  or 
phobias.  There  is  aerophobia  —  the  dread  of  air.  Some  patients 
are  particularly  afraid  of  night  air,  just  as  if  after  sunset  there 
was  any  other  sort  of  air  to  be  had. 

Hydrophobia  means  literally  the  dread  of  water,  but  in  these 
days  it  has  come  to  be  applied  to  a  well  defined  disease  acquired 
from  the  bite  of  a  mad  dog  —  rabies;  although  it  would  seem 
there  are  still  to  be  found  certain  strata  of  society  who  may  be 
said  to  possess  more  or  less  of  a  well  defined  dread  of  water  as 
regards  both  its  internal  use  and  external  application. 

Then  we  have  aichmophobia  —  the  dread  of  pointed  tools  or 
instruments.  I  have  a  patient  at  the  present  time  who  says  that 
when  she  gets  a  glimpse  of  any  sharp  or  pointed  instrument  such 
as  a  pair  of  scissors,  she  is  seized  with  a  desire  to  stab  herself 
or  else  is  tormented  with  the  fear  that  she  will  harm  some  one 
else. 

Kenophobia  stands  for  the  dread  of  emptiness,  and  there  are 
those  victims  of  chronic  fear  who  could  not  possibly  be  dragged 
into  an  empty  house  or  vacant  building.     I  have  just  received  a 

95 


96  WORRY  AND  NERVOUSNESS 

letter  from  a  patient  who  says  her  life  has  been  ruined  by  the 
constant  dread  of  "  going  away  from  home." 

Sitophobia  is  the  dread  of  food  and  is  often  found  in  well 
marked  melancholia,  while  a  specialized  form  of  this  fear  —  a 
dread  of  some  particular  article  of  food  —  is  not  uncommon  in 
neurasthenics.  Brontophobia,  or  the  fear  of  thunder  is  a  dread 
commonly  met  with,  and  one  that  is  greatly  aggravated  by  the 
manner  in  which  nervous  adults  exhibit  their  fears  during  an 
electrical  storm  in  the  presence  of  young  children. 

Some  people  are  greatly  disturbed  by  regularly-dropping 
water  —  as  from  an  eavestrough  or  faucet.  The  Chinese  are 
said  to  put  their  enemies  to  death  by  having  a  drop  of  water  fall 
at  regular  intervals  upon  the  top  of  the  head. 

Phobophobia  is  nothing  more  nor  less  than  the  dread  of  dread- 
ing, and  some  chronic  worriers,  it  would  seem,  when  they  have 
nothing  more  definite  to  be  afraid  of,  are  easily  able  to  work  up 
a  case  of  phobophobia. 

In  dealing  with  nervous  sufferers,  it  is  my  practice  not  to 
make  use  of  these  high  sounding  terms  in  discussing  the  patient's 
fears  and  dreads.  It  is  disconcerting  and  tends  unduly  to 
frighten  these  nervous  sufferers  to  be  told  they  are  suffering 
from  this  phobia  or  that  phobia.  I  must  prefer  to  use  a  plain 
English  word,  telling  my  patients  they  are  victims  of  this  fear 
and  that  dread,  and  let  it  go  at  that. 

ALTITUDE    AND    SPACE    DREADS 

It  has  been  my  observation  that  practically  everybody  has  a 
sort  of  instinctive  dread  or  fear  of  looking  down  from  great 
heights.  The  majority  of  people  are  able  largely  to  conquer  this 
fear  of  great  heights  —  otherwise  known  as  acrophobia.  Struc- 
tural iron  workers  employed  in  erecting  our  modern  steel  sky- 
scrapers are  able,  little  by  little,  to  master  this  inherent  dread 
of  great  heights  to  such  an  extent  that  almost  any  day  one  may 
see  these  workers  standing  or  walking  on  steel  beams  twenty- 
five  or  thirty  stories  up  in  the  air.  It  makes  most  of  us  feel 
a  little  chilly  up  and  down  the  spine  when  we  see  a  steeple- jack 
perched  high  up  on  some  lofty  smokestack. 

Workmen  have  told  me  that  they  had  gradually  to  accustom 


Fig.  4.  The  Fear  of  Great  Heights 


FEAR  AND  DEFINITE  DREADS  97 

themselves  to  these  great  heights,  and  that  at  first  they  were  in 
constant  danger  of  losing  their  balance  if  they  permitted  them- 
selves to  look  too  steadfastly  at  the  ground;  and  it  is  a  well- 
known  fact  that  in  case  of  an  accidental  fall  on  the  part  of  a 
workman  employed  on  one  of  these  high  buildings,  the  rest  of  the 
force  usually  quit  work  for  that  day.  It  requires  a  night's  sleep 
to  restore  their  nerve.     (Fig.  4.) 

The  physical  basis  of  this  form  of  fear  is  probably  to  be  found 
in  the  fact  that  we  have  habitually  trained  our  eyes  to  look  upon 
objects  near  at  hand,  and,  therefore,  when  we  are  suddenly  and 
unexpectedly  compelled  to  look  out  upon  objects  at  an  unaccus- 
tomed distance  from  our  position,  the  novelty  of  the  situation  is 
found  to  be  more  or  less  disconcerting  to  one's  mental  and  nerv- 
ous equilibrium. 

It  is  not  always  great  heights  that  produce  this  fear  or  dread. 
We  know  of  patients  who  are  exquisitely  tortured  if  they  are 
compelled  to  sit  in  the  front  row  of  the  balcony  in  some  place  of 
public  amusement ;  while  not  long  since  we  were  consulted  by  a 
clergyman  whose  very  success  and  usefulness  were  jeopardized 
by  the  definite  dread  that  he  would  some  time  jump  from  or  fall 
off  the  pulpit.  This  fear  never  ceased  to  tantalize  him  through- 
out every  discourse  he  delivered. 

Akin  to  this  fear  of  altitude  is  the  fear  of  going  alone  across 
open  spaces  —  agoraphobia.  This  is  a  form  of  fear  that  some 
nervous  people  suffer  from  throughout  a  lifetime.  Many  of  these 
persons  who  could  not  possibly  be  persuaded  to  traverse  a  large 
open  space  alone  are  entirely  content  to  make  the  journey  when 
accompanied  by  even  a  small  child. 

Another  fear  pertaining  to  space  is  that  of  claustrophobia  — 
the  fear  of  closed  spaces.  Some  people  are  very  nervous  when 
they  are  compelled  to  walk  through  a  narrow  street,  having  high 
buildings  on  either  side.  Others  become  nervous,  fidgety,  and 
sometimes  pale  with  fear,  wThen  an  elevator  door  closes  and  they 
find  themselves  actually  shut  up  in  a  steel  cage.  They  are  almost 
overwhelmed  with  a  desire  to  try  to  make  their  escape  even 
while  the  elevator  is  in  motion.  A  milder  form  of  this  same 
dread  is  observed  in  those  travelers  who  horribly  dislike  to  be 
forced  to  sit  in  the  same  seat  with   another  passenger.     They 


98  WORRY  'AND  NERVOUSNESS 

have  an  unnatural  fear  of  being  crowded.  When  in  other  tight 
places,  they  find  breathing  difficult,  cold  perspiration  breaks  out 
on  the  face,  and  they  are  seized  with  an  almost  uncontrollable 
desire  to  tear  themselves  away,  to  jump  out,  etc.,  etc. 

THE    DREAD    OF    DISEASE,    DIRT    AND    DEATH 

It  is  a  well  known  fact  that  patients  suffering  from  locomotor 
ataxia  entertain  such  definite  fears  of  being  unable  to  walk 
(basophobia)  as  greatly  to  aggravate  their  malady  and  still 
further  decrease  their  powers  of  locomotion.  I  have  no  doubt 
that  many  of  the  hysterical  palsies  are  in  reality  due  to  these 
same  definite  dreads.  Some  authorities  even  claim  that  vertigo 
and  blushing  (erythrophobia)  may  result  in  this  same  manner 
when  the  fear  of  them  has  come  to  possess  the  patient. 

The  dread  of  dirt  (misophobia)  has  grown  vastly  in  re- 
cent years,  and  is  closely  related  to  microphobia  (the  fear  of 
microbes  or  germs).  Some  of  these  unfortunate  sufferers 
will  wash  their  hands  no  less  than  fifty  times  a  day.  They  are 
afraid  to  shake  hands  with  their  neighbors  and,  as  one  might 
easily  imagine,  afraid  to  greet  a  long  absent  friend  with  an 
affectionate  kiss.  We  knew  of  a  young  man  who  would  never 
go  anywhere  alone,  for  fear  he  would  be  compelled  to  touch  a 
door  knob.  We  recently  had  a  patient  who  had  made  herself 
a  semi-nervous  invalid,  trying  to  disinfect  the  house  and  other- 
wise fight  the  myriads  of  microbes  which  all  the  while  lurked 
near  her.  She  was  only  helped  by  persistent  training  along 
those  lines  which  served  to  show  her  that  the  normal  healthy 
man  was  mightier  than  the  microbe. 

Pathophobia  is  the  dread  of  disease,  and  many  indeed  are  its 
specialized  forms  —  far  too  many  to  receive  consideration  here. 
It  is  an  old  proverb  that  "  a  little  knowledge  is  a  dangerous 
thing,"  and  this  is  certainly  true  in  matters  of  personal  health 
and  hygiene.  Unless  we  can  teach  the  individual  a  sufficient 
amount  of  truth  to  deliver  him  from  groundless  fears  and  base- 
less dreads,  it  would  otherwise  seem,  that  all  our  half-way 
efforts  to  enlighten  him  had  only  increased  his  worries  and  fur- 
ther multiplied  his  ungrounded  fears  of  disease. 

Phthisiophobia  —  the  fear  of  tuberculosis,  is  one  which  the 


FEAR  AXD  DEFIXITE  DREADS  99 

average  person,  at  least  in  some  measure,  is  beginning  to  recover 
from. 

The  dread  of  insanity  constantly  hovers  over  some  nervous 
patients  who  may  have  been  so  unfortunate  as  to  have  had  an 
insane  relative  or  ancestor.  Such  patients  are  terribly  depressed 
by  even  hearing  the  term  mentioned,  while  the  sight  of  an  insane 
asylum,  even  from  a  passing  train,  is  enough  to  disturb  them 
for  weeks  afterwards. 

Metchnikoft  looks  upon  even  the  dread  of  death  as  an  un- 
natural form  of  fear.  He  thinks  that  all  persons  that  have 
lived  anything  like  the  normal  life  should  come  to  look  upon 
death  without  the  least  thought  of  fear.  And  it  would  certainly 
seem  that  men  and  women  who  entertain  the  Christian  hope  of 
the  life  beyond,  should  come  to  look  upon  death  without  dread 
and  without  fear.  Much  less  is  there  excuse  for  the  extraordi- 
nary dread  some  people  entertain  of  viewing,  touching  or 
handling  the  dead  body. 

ANIMALS    AXD    THE    DARK 

Zoophobia  (the  fear  of  animals)  is  a  form  of  ever  present 
dread,  which  tortures  countless  thousands  of  otherwise  brave 
and  normal  people.  And  one  hardly  feels  like  trying  utterly, 
to  eradicate  this  fear  of  animals  as  long  as  mad  dogs  are  allowed 
to  prowl  about  the  streets  of  our  cities  and  villages.  But  when 
this  fear  of  animals  becomes  a  veritable  obsession  as  in  the 
case  of  some  persons  in  their  fear  of  snakes,  mice,  or  spiders, 
it  certainly  needs  to  be  combated,  even  as  it  does  also  in  those 
cases  of  the  silly  and  ridiculous  fear  of  cats  (ailurophobia). 
We  recently  had  a  patient  who  was  almost  certain  to  have  a 
hysterical  fit  if  left  alone  in  a  room  with  a  cat,  even  but  for 
a  few  brief  moments.  And  I  am  bound  to  confess  that  this 
woman  was  by  no  means  neurasthenic  —  it  was  simply  a  case 
of  crystalized  fear  —  definite  dread. 

The  fear  of  cats  is  so  great  with  some  persons  as  to  preclude 
their  wearing  furs  derived  from  any  member  of  the  cat  family; 
while  others  are  so  sensitive  on  this  point,  that  they  are  able 
to  detect  the  presence  of  a  cat  in  the  room  or  even  in  the  house 
by  the  sense  of  smell.     Weir  Mitchell,  in  his  essay  on  this  sub- 


ioo  WORRY  ASD  NERVOUSNESS 

ject,  cited  numerous  cases  which  showed  beyond  question  that 
certain  nervous  women  are  possessed  of  an  extraordinarily  acute 
sense  of  smell  as  regards  the  detection  of  these  special  odors; 
while  Scripture  reports  the  case  "  of  a  woman  in  charge  of  a 
boarding  school  who  always  sorted  the  boys'  linen  after  the 
wash  by  the  odor  alone.*' 

From  earliest  infancy  some  otherwise  normally  healthy  per- 
sons have  grown  up  possessed  of  an  absurd  dread  of  the  dark. 
Many  of  them  will  positively  refuse  to  sleep  in  a  room  at  night 
without  some  form  of  low-burning  light.  If  such  persons  at- 
tempt to  sleep  in  a  dark  room,  they  are  made  inordinately  nerv- 
ous by  every  form  of  sound,  both  real  and  imaginary.  The 
wind,  the  doors,  the  windows,  the  creaking  of  the  floor  and 
what-not,  all  serve  to  alarm  them  as  effectually  to  prevent  rest 
and  sleep. 

We  all  know  of  nervous  women  as  well  as  men,  who  live  in 
constant  fear  of  finding  some  one  in  a  dark  room.  Before  re- 
tiring at  night  they  never  fail  to  look  under  the  bed. 

Xow  this  fear  of  the  dark  i<=  regarded  by  many  as  cowardice. 
but,  in  my  opinion,  it  has  its  origin  back  in  the  early  childhood 
days  when  parents  and  nurses  thoughtlessly  frightened  the  little 
ones  when  they  said  "  Boo,  Dark  "  or  when  they  threatened 
them  with  the  "  boogie  man."  "  hobgoblins."  and  "  the  bad  man." 

DREAMS    AND    MEMORY    DREADS 

It  not  infrequently  happens  that  some  definitely  experienced 
dread  has  its  origin,  maybe  unconsciously,  away  back  in  the 
individual's  life,  in  the  form  of  some  alarming  experience  or 
some  tragic  accident.  Subconsciously,  as  it  were,  this  memory 
fear  is  passed  on  down  through  the  experience  of  subsequent 
years  and  is  ever  present,  always  ready  to  alarm  and  demoralize 
the  individual  in  a  most  bewildering  manner  —  and  all  this  it 
does,  while  the  fear-ridden  sufferer  is  quite  unable  to  explain 
either  the  origin  or  basis  of  his  unnatural  fears  and  abnormal 
dreads. 

Likewise  are  the  unremembered  dreams  of  the  night  season 
able  to  extend  over  their  fears  and  dreads  into  the  working 
hours,   and   are   able  thus   unconsciouslv.   to   torment   and   tor- 


FEAR  AXD  DEFINITE  DREADS  101 

ture  the  innocent  and  susceptible  nervous  sufferer.  .  There  is 
no  doubt  in  my  mind  but  that  the  unr-emembered  expeiiences 
of  a  frightful  nightmare  are  perfectly  able  to  render  the  pa- 
tient so  nervous  and  uneasy  as  almost  entirely  to  unfit  him  for 
the  performance  of  his  customary  duties  the  following  day. 

PREMONITIONS 

The  belief  in  premonitions  is  based  upon  superstition,  sug- 
gestion, and  fear.  Some  people  are  subject  to  definite  premoni- 
tions, such  as  the  dread  of  a  fire,  a  train  wreck,  or  a  street 
accident.  Others  suffer  from  a  generalized  premonitory  state 
of  mind  —  the  vague  and  depressing  fear  that  something  awful 
is  going  to  happen.  A  common  premonition  is  that  of  a  loss  of 
health  or  early  death. 

Premonitions  are  indicative  of  lax  mental  discipline,  and 
serve  to  show  that  the  mind  is  permeated  with  fear  and  domi- 
nated by  dread.  It  is  my  opinion  that  the  popular  belief  in 
premonitions  is  originated  and  fostered  by  the  newspaper  pub- 
lication of  stories  about  persons  who  were  possessed  of  an 
impending  sense  of  danger  or  doom  —  or  who  had  a  definite  pre- 
monition that  some  accident  was  about  to  happen  —  and  then 
something  really  did  happen.  While  the  larger  part  of  these 
stories  which  appear  in  the  papers  may  not  be  true,  neverthe- 
less, their  influence  is  such  as  to  further  foster  this  lingering 
superstition  in  the  reliability  of  premonitions.  The  newspapers 
do  not  bother  themselves  to  publish  the  accounts  of  those  untold 
thousands  of  cases  where  premonitions  failed  —  neither  do  we 
take  the  trouble  to  remember  these  cases. 

People  are  more  subject  to  premonitions  on  dark  and  dis- 
mal days.  They  are  also  more  common  in  the  spring  and  the 
fall.  This  particular  form  of  dread  is  also  greatly  increased 
by  suggestion.  I  well  recall  a  case  of  a  suburban  wreck  a  few 
years  ago.  in  which  the  front  coach  was  badly  demolished, 
and  I  noticed  that  for  months  and  even  years  after  this  acci- 
dent, that  the  passengers  studiously  avoided  that  front  coach. 
There  was  an  immediate  decrease  in  the  number  of  people  who 
would  allow  themselves  to  ride  in  that  car.  The  soil  and  the 
seed  for  suggestion  are  both  needed  to  produce  premonitions. 


102  WORRY  AND  NERVOUSNESS 

MEMORY    DECEPTIONS 

Royce  thinks  that  many  supposedly  fulfilled  premonitions  are 
really  pseudo-presentiments  —  a  sort  of  hallucination  of  mem- 
ory that  twists  and  deceives  us  into  believing,  after  the  thing 
has  happened  —  that  we  had  either  dreamed  of  it  previously  or 
had  a  premonition.  This  is  in  harmony  with  Podmore's  sug- 
gestion of  how  a  tricky  memory  may  instantaneously  rearrange 
the  details  of  a  dream  or  premonition  to  make  it  fit  into  the 
actual  occurrences.  It  is  certain  that  no  reliance  can  be  placed 
on  stories  of  dream  fulfillment  unless  the  dream  was  told  or 
written  out  beforehand. 

Since  the  vast  majority  of  people  are  having  premonitions 
every  day,  and  dreaming  dreams  every  night,  it  is  not  to  be 
wondered  at  that  now  and  then  one  or  two  should  appear  to 
come  true  or  be  fulfilled.  These  rare  cases  are  then  published 
broadcast  and  ten  thousand  more  nervous  invalids  begin  to  hatch 
out  a  new  brood  of  foolish  worries  and  silly  dreads.  That  a 
premonition  will  occasionally  come  true,  may  be  accepted  as  a 
reasonable  guess  as  shown  by  the  mathematics  of  coincidences 
as  based  upon  the  theory  of  probabilities. 

ORIGIN    OF   PREMONITIONS 

The  further  origin  of  premonition  is  discovered  in  the  pros- 
titution of  reasonable  forethought  and  care.  There  is  certainly 
nothing  abnormal  but  everything  commendatory  in  a  stranger's 
careful  examination  of  the  exits,  fire  escapes,  etc.,  connected 
with  his  sleeping  apartments  in  a  strange  hotel;  but  when  pre- 
cautionary instinct  is  allowed  to  degenerate  into  a  definite  dread 
of  the  hotel's  burning  up  on  that  particular  night,  it  is  then 
that  the  patient  has  become  a  victim  of  this  harmful  sort  of 
fear  called  premonition.  Think  of  all  San  Francisco's  inhabi- 
tants, who  for  years  may  have  had  earthquake  premonitions 
which  were  never  realized,  and  then  how  innocently  they  all 
retired  the  evening  before  the  great  shake,  wholly  free  from 
premonitions  of  what  was  about  to  occur ;  but  on  being  shaken 
cut  of  bed  early  the  next  morning  were  able  immediately  to 
conjure  up  the  memory  of  some  former  earthquake  premonition 


FEAR  AXD  DEFIXITE  DREADS  103 

and  actually  to  deceive  themselves  into  believing  that  they  had 
had  such  a  presentiment  the  evening  before. 

UNFULFILLED    PRESENTIMENTS 

I  have  found  it  helpful  in  dealing  with  my  patients  who  tor- 
ture themselves  with  premonitions,  to  emphasize  cases  in  my 
own  experience  which  have  not  been  fulfilled.  I  have  often 
used  in  this  connection  the  story  of  Carl  Schurz  as  told  in  his 
"  recollections."  General  Schurz  describes  how,  on  the  morn- 
ing of  the  battle  of  Chancellorsville,  he  awoke  with  the  pro- 
found conviction  —  a  veritable  premonition  —  that  his  time  had 
come,  that  he  would  be  killed  in  that  day's  battle.  He  had  never 
had  such  a  premonition  before.  He  had  heard  of  other  cases 
where  such  presentiments  were  the  forerunner  of  death.  He 
tried  to  shake  off  this  fear,  but  it  gripped  him;  he  was  unable 
to  free  himself  from  it.  As  the  day  went  on  the  conviction 
grew,  and  finally  he  sat  down  and  wrote  farewell  letters  to  his 
family,  and  then  he  went  forth  into  the  battle.  And  when  his 
corps  was  summoned  onto  the  firing  line,  he  then  knew  that 
his  premonition  was  genuine  and  he  plunged  into  the  fight  with 
the  full  conviction  that  the  end  was  nigh ;  but  he  was  a  sturdy 
German  and  a  well  trained  soldier,  and  history  shows  how  well 
he  kept  his  courage  and  how  splendidly  he  managed  his  troops; 
but  his  deadly  premonition  did  not  leave  him  until,  while  rid- 
ing to  the  front,  his  aide-de-camp  was  cut  down  by  a  cannon 
ball.  Upon  seeing  his  aid  shot  down,  the  fear  of  death  departed 
from  the  general's  mind,  in  the  same  unreasoning  manner  in 
which  it  had  come.  His  fear  was  gone,  he  plunged  into  the 
thickest  of  the  fight,  and  came  out  —  untouched. 

And  this  story  splendidly  illustrates  two  points:  first,  even  a 
strong-minded,  well-trained  soldier,  may  have  premonitions  of 
fear;  and,  second,  that  all  of  us  live  to  have  many,  many,  pre- 
monitions, most  of  which  never  happen. 

THE  TREATMENT  OF  DREADS 

While  the  details  of  the  treatment  of  these  various  nervous 
states  is  reserved  for  consideration  in  later  chapters,  it  will  not 
be  out  of  place  to  offer  brief  remedial  suggestions  here. 


104  WORRY  AND  NERVOUSNESS 

The  one  thing  essential  in  overcoming  chronic  dreads  is  sim- 
ple, methodic,  mental  discipline.  It  you  can  walk  without  fear 
along  a  wooden  beam  ten  inches  wide  when  elevated  one  foot 
above  the  ground,  common  sense  goes  to  show  that  it  is  only  a 
matter  of  confidence,  practice  and  experience  —  mental  disci- 
pline —  until  you  can  walk  on  an  iron  beam,  ten  inches  wide  two 
hundred  feet  above  the  ground  if  necessary.  This  is  exactly 
the  way  the  builder  effectually  overcomes  this  inherent  fear 
of  great  heights.  And  it  serves  the  purpose  of  a  practical 
illustration,  showing  just  how  all  crystalized  fears  and  definite 
dreads  may  be  successfully  mastered. 

Like  a  horse  that  shies,  the  victim  of  dreads  should  deliber- 
ately, methodically  and  persistently  drive  himself  right  up  face 
to  face  with  his  hoodoo  and  bravely  assault  the  psychological 
enemy.  He  should  attack  these  peculiar  forms  of  fear  just  as 
he  would  the  more  silly  and  superstitious  hoodoos  of  "  Friday 
the  thirteenth,"  or  the  supposed  unluckiness  of  sitting  down 
with  thirteen  at  the  table. 

I  help  many  of  my  patients  over  these  dreads  by  telling  them 
that  they  are  practically  universal ;  that  is,  that  practically 
everybody  has  or  has  had  at  some  time  or  other,  one  or  more 
of  these  petty  fears.  As  they  laugh  at  other  people's  fears, 
it  helps  them  to  laugh  at  their  own.  They  are  altogether  too 
likely  to  regard  their  fears  as  unusual  and  unique  and  it  rather 
helps  them  to  find  out  that  they  are  little  different  from  other 
people,  except  for  the  fact  that  they  take  their  fears  and  dreads 
too  seriously. 

SUMMARY    OF    THE    CHAPTER 

i.  Victims  of  so-called  "  phobias  "  are  suffering  from  common 
everyday  dreads  —  only  they  have  come  to  dread  their  dreads. 

2.  Common  among  these  crystallized  fears  and  definite  dreads 
may  be  mentioned  aerophobia —  the  dread  of  air. 

3.  Other  dreads  are  hydrophobia — fear  of  water;  aichmo- 
phobia  —  dread  of  pointed  tools;  kenophobia  —  the  dread  of 
emptiness;  sitophobia  —  the  dread  of  food;  brontophobia  —  the 
fear  of  thunder;  and  phobophobia  —  the  dread  of  dreading. 

4.  In  dealing  with  nervous  patients  it  is  best  not  to  use  these 
mouth-fiHing^  Greek  words  to  describe  their  fears.  Use  a  simple 
English  word  and  call  them  dreads. 


FEAR  AND  DEFINITE  DREADS  105 

5.  Acrophobia  —  the  instinctive  fear  of  heights  —  is  a  well- 
nigh  universal  dread.  But  reason,  practice,  and  perseverance 
are  able  practically  to  cure  it. 

6.  This  fear  of  heights  —  small  and  great  —  rests  on  a  physical 
basis.  It  results  from  the  fact  that  our  eyes  are  trained  to  view 
objects  near  at  hand,  so  that  a  sudden  view  from  a  high  point 
disconcerts  the  nervous  equilibrium. 

7.  The  dread  of  small  heights  is  also  common.  Women  fear 
to  sit  in  the  front  row  of  the  balcony  at  the  theater  and  clergy- 
men fear  they  will  fall  off  their  pulpits. 

8.  Agoraphobia  is  the  dread  of  open  spaces;  while  claustro- 
phobia is  the  fear  of  closed  spaces  —  the  dread  of  entering  ele- 
vators, sitting  in  tight  places,  etc. 

9.  Certain  people  live  in  constant  dread  of  dirt  —  misophobia; 
while  others  are  kept  miserable  by  the  fear  of  germs  —  micro- 
phobia.  They  are  engaged  constantly  in  washing  their  hands 
and  otherwise  trying  to  avoid  contamination. 

10.  Pathophobia  is  the  dread  of  disease,  and  thousands  live  in 
constant  fear  of  bodily  disorders  which  are  in  no  danger  of 
overtaking  them. 

11.  Some  nervous  patients  who  have  had  an  insane  relative  or 
ancestor  live  all  their  lives  tormented  by  the  fear  that  they  may 
go  crazy. 

12.  The  fear  of  death  is  regarded  by  Metchnikoff  as  an 
unnatural  dread.  At  least  it  would  seem  that  a  Christian's  hope 
would  rob  death  of  all  dread. 

13.  Zoophobia  —  the  fear  of  animals  —  is  variously  mani- 
fested as  a  dread  of  snakes,  spiders,  mice,  and  mad  dogs,  experi- 
enced by  so  many  otherwise  brave  and  normal  people. 

14.  One  of  the  most  silly  of  all  animal  dreads  is  the  prepos- 
terous fear  of  cats  (ailurophobia)  which  certain  individuals  so 
persistently  entertain. 

15.  From  earliest  infancy  some  people  have  grown  up  pos- 
sessed of  an  absurd  dread  of  the  dark.  They  think  they  cannot 
sleep  in  a  room  without  a  light  and  are  tremendously  annoyed  by 
sounds  of  all  descriptions. 

16.  Much  of  this  fear  of  the  dark  probably  has  its  origin  in 
hobgoblin  stories  and  the  bogy  man  threats  of  early  childhood. 

17.  Definite  dreads  may  have  their  origin  in  some  long  for- 
gotten alarming  experience,  tragic  accident,  or  in  some  vivid 
dream.     It  persists  as  a  sort  of  unconscious  memory  dread. 

18.  Premonitions  are  based  on  superstition,  suggestion,  and 
fear.  They  may  be  definite  —  as  dread  of  an  accident  —  or 
general  —  as  the  presentiment  that  something  awful  is  going  to 
happen. 

19.  Newspaper  stories  of  fulfilled  premonitions  tend  to  keep 


106  WORRY  AND  NERVOUSNESS 

alive  this  silly  superstition.     People  are  more  subject  to  these 
fears  on  dismal  days,  and  in  the  spring  and  fall. 

20.  Tricks  of  memory  sometimes  deceive  us  into  believing  we 
have  had  a  dream  or  premonition  after  things  have  happened. 

21.  Premonitions  may  originate  in  the  prostitution  of  ordinary 
forethought  and  reasonable  precaution  —  as  in  locating  fire 
escapes  in  a  strange  hotel. 

22.  Study  unfulfilled  premonitions  and  remember  that  we  are 
all  more  or  less  subject  to  these  silly  fears,  and  that  we  all  live 
to  have  many,  many  premonitions  —  the  vast  majority  of  which 
never  happen. 

23.  The  essential  thing  in  the  treatment  of  these  common 
dreads  is  simple,  methodic,  mental  discipline.  Treat  yourself 
like  a  shying  horse  —  drive  right  up  face  to  face  with  your  fears 
—  and  teach  yourself  how  to  laugh  at  your  own  fears  —  just  as 
merrily  as  you  laugh  at  other  people's  silly  dreads. 


CHAPTER  IX 
M  AMERICANITIS,"  OR  THE  HIGH  PRESSURE  LIFE 

WHILE  we  have  emphasized  the  influence  of  the  heredi- 
tary factors  in  the  causation  of  worry  and  nervousness, 
nevertheless,  we  are  not  unmindful  of  the  fact  that  our  modern 
strenuous  methods  of  work  and  habits  of  living  may  have  some- 
thing to  do  with  the  alarming  present-day  increase  in  those 
nervous  disorders  commonly  embraced  in  the  terms  "  neu- 
rasthenia "  and  "  nervous  prostration." 

The  American  people,  especially,  are  more  and  more  addicting 
themselves  to  a  combination  of  mental  habits  and  physical  prac- 
tices which  are  directly  and  indirectly  responsible  for  increas- 
ing nervous  tension  together  with  raising  the  blood-pressure, 
thus  laying  the  foundation  for  those  typical  cases  of  nervous 
collapse  commonly  spoken  of  as  "  nervous  breakdown,"  "  neu- 
rasthenia," etc.,  and  which  are  usually  accompanied  by  low  or 
lowered  blood-pressure,  great  nerve-weakness,  and  a  general 
all  around  "  rundown  feeling."  We  are  more  and  more  in- 
clined to  the  belief  that  it  is  the  strenuous  living  and  not  stren- 
uous working  that  is  largely  responsible  for  all  this  increase 
in  nervous  trouble.  While  modern  life  may  be  more  complex, 
it  is  also  becoming  more  and  more  simplified.  We  certainly 
do  more  work,  but  we  have  better  system  and  more  machinery 
to  do  it  with. 

THE  SIGNIFICANCE  OF  BLOOD  PRESSURE 

In  this  connection  it  may  be  well  to  offer  a  word  of  expla- 
nation as  to  the  method  of  taking  blood-pressure,  and  as  to  the 
standards  of  normal  blood-pressure.  There  have  been  devised 
a  number  of  instruments  having  attachments  which  can  be 
strapped  around  the  arm,  so  that  by  means  of  pumping  air  into 
a  little  rubber  bag  underneath,  pressure  can  be  applied  to  the 

107 


io8  WORRY  AND  NERVOUSNESS 

blood  vessels  of  the  arm.  By  means  of  a  rubber  tube,  this  air- 
pressure  is  communicated  to  a  chamber  containing  mercury 
and  surmounted  by  a  glass  tube  marked  with  a  millimeter  scale, 
arranged  somewhat  after  the  plan  of  a  barometer.  The  pres- 
sure is  now  gradually  removed  until  the  pulse  at  the  wrist  can 
just  be  felt,  and  then  on  the  graduated  glass  tube  is  read  off 
just  how  many  millimeters  of  mercury  are  equivalent  to  the 
patient's  blood-pressure. 

An  ordinary  healthy  adult  under  forty-five  years  of  age  has 
a  blood-pressure  varying  from  no  to  130  millimeters  of  mer- 
cury (about  five  inches  in  English  measurement).  A  series  of 
five  thousand  apparently  healthy  adults,  tested  during  the  last 
seven  years,  showed  a  general  average  of  123  millimeters.  The 
ages  of  this  group  ran  from  twenty  to  forty-five  years. 

The  one  thing  characteristic  of  the  present-day  social  and 
commercial  world  is  its  high  tension ;  so  many  people  are  keyed 
up  to  the  last  notch.  People  are  living  at  a  fierce  pace,  and 
the  pressure-gauge  of  life  for  many  registers  all  the  while  dan- 
gerously near  the  bursting  point.     (Fig.  5.) 

High  blood-pressure  (or  secondary  low  pressure)  is  directly 
and  indirectly  responsible  for  numerous  bodily  ailments  and 
certain  grave  physical  catastrophes,  and  is  intimately  connected 
with  such  serious  disorders  as  chronic  headaches,  arteriosclero- 
sis or  hardening  of  the  arteries,  apoplexy  and  its  subsequent 
paralysis,  heart-failure,  Bright's  disease,  insomnia,  neurasthenia, 
chronic  congestions  and  certain  forms  of  insanity. 

HIGH    BLOOD-PRESSURE 

There  are  numerous  substances  which,  when  taken  into  the 
body,  together  with  certain  mental  states,  have  power  to  influ- 
ence the  blood-pressure,  some  lowering  it,  while  others  cause 
it  to  rise.  Now,  when  the  blood-pressure  is  raised,  it  will  be 
seen  at  once  that  more  blood  will  circulate  through  the  brain  as 
well  as  through  other  parts  of  the  body:  and  therefore,  when 
the  blood-pressure  is  moderately  high,  since  the  blood  is  that 
which  nourishes  the  body  and  gives  it  life,  it  will  not  be  hard 
to  imagine  that  the  patient  will  feel  exhilarated  and  buoyant, 
able  to  enter  the  arena  of  societv  and  business  more  confident 


Speeding  up  the  Machines 


The  Rush  and  Traffic  Congestion  of  a  Great  City 
FIG.  5.  THE  HIGH  TENSION  OF  MODERN  LIFE 


THE  HIGH  PRESSURE  LIFE  [og 

of  success,  with  hopes  and  courage  all  at  top-notch.  (Fig.  5.) 
On  the  other  hand,  excessively  and  abnormally  low  blood-pres- 
sure produces  such  a  sense  of  weakness,  debility,  and  mental 
lethargy  as  to  constitute  a  powerful  temptation  to  resort  to 
some  convenient  and  artificial  method  of  toning  up  the  system 
—  raising  the  blood-pressure. 

In  this  chapter  we  are  concerned  chiefly  with  the  important 
fact  that  fear  and  worry  and  all  their  psychic  cousins  are  able 
actually  to  raise  the  blood-pressure  to  that  point  where  real 
damage  results  to  the  health,  and  to  such  an  extent  as  to  create 
and  confirm  the  demand  for  the  use  of  certain  drugs  highly 
injurious  to  the  physical,  mental,  and  moral  welfare  of  the  in- 
dividual and  the  race.  We  refer  to  morphine,  alcohol,  the 
V>romides,  and  a  host  of  headache  powders,  quieting  remedies, 
and  pain  relievers.  While  it  is  foreign  to  the  purposes  of  this 
chapter  to  consider  the  right  and  proper  methods  of  controlling 
high  blood-pressure,  other  than  the  influence  of  the  mental 
states,  these  questions  have  been  fully  treated  in  another  work. 
In  a  former  chapter,  attention  was  called  to  the  fact  that  faith 
and  trust  contributed  to  normalizing  the  blood-pressure. 

WORRY    A    CAUSE    OF    HIGH    BLOOD-PRESSURE 

There  came  to  the  clinic,  one  rainy  morning,  an  ex-convict 
who  wore  a  worried  expression,  complained  of  inability  to  sleep 
and  loss  of  appetite,  and  examination  revealed  a  blood-pressure 
of  190  millimeters.  Subsequent  inquiry  disclosed  the  fact  that 
this  man  was  living  in  constant  dread  of  being  arrested  and 
returned  to  the  penitentiary  on  the  ground  of  "  once  a  criminal 
always  a  criminal." 

Physical  examination,  including  the  kidneys,  blood  vessels, 
and  heart,  in  no  way  accounted  for  his  high  blood-pressure.  This 
condition  of  things  continued  for  over  two  weeks,  then  on  being 
assured  that  he  would  have  thirty  days  immunity  from  arrest 
if  he  would  faithfully  perform  the  duties  assigned  him,  he 
admitted  that  his  chief  trouble  was  incessant  worry  and  con- 
stant anxiety.  Within  a  very  few  minutes  his  blood-pressure 
actually  began  to  drop,  and  within  three  hours  it  had  fallen  20 
mm.,  and  by  the  following  day  had  reached  155  mm.,  a  total 


no  WORRY  AND  NERVOUSNESS 

fall  of  35  mm.  This  seems  to  be  a  reasonably  clear  case  of  high 
blood-pressure  from  fear  and  worry.  It  was  largely  relieved  by 
setting  the  mind  at  rest.  The  arterial  tension  was  lowered  by 
the  relief  of  the  mental  tension.  Three  months  after  these 
observations,  several  tests  showed  this  man's  blood-pressure  to 
register  uniformly  in  the  neighborhood  of  150. 

SUDDEN     EMOTIONAL    CHANGES 

A  few  years  ago  the  author  had  an  opportunity  to  observe  a 
series  of  rapid  and  unusual  fluctuations  in  blood-pressure  on  the 
part  of  a  nervous  and  semi-hysterical  young  woman.  Pres- 
sures taken  just  before  and  after  the  receipt  of  a  bit  of  bad 
news,  exhibited  a  difference  of  over  50  mm.  We  were  able  to 
detect  a  difference  of  20  to  30  mm.  during  a  single  observation, 
as  a  result  of  purely  emotional  disturbances.  Such  a  high  de- 
gree of  vaso-motor  instability  is  rather  unusual. 

Sudden  excitement,  burning  indignation,  intense  anger,  and 
keen  disappointment  all  serve  instantly  to  alter  the  blood-pres- 
sure. It  is  not  uncommon  to  observe  an  alteration  of  pres- 
sure varying  from  10  to  25  per  cent,  and  so  it  appears  that  the 
highly  emotional  person  is  constantly  altering  his  blood-pressure, 
and,  as  a  consequence,  necessitating  more  or  less  of  a  complete 
rearrangement  of  the  circulatory  apparatus,  and  a  readjustment 
of  the  whole  process  of  nutrition  and  metabolism. 

NERVOUS   PROSTRATION   AND  LOW   BLOOD-PRESSURE 

Not  only  will  ceasing  to  worry  serve  to  reduce  blood-pressure 
in  cases  where  the  high  tension  is  wholly  or  partially  due  to 
psychic  causes,  but  a  change  in  the  mental  state  is  also  some- 
times able  to  raise  the  blood-pressure  in  certain  cases  of 
neurasthenia  or  so-called  nervous  prostration.  Nervous  prostra- 
tion is  one  of  nature's  ways  of  preventing  certain  high-strung 
people  from  actually  "  blowing  up."  Nature  removes  the  pen- 
dulum and  allows  them  to  run  down,  thus  preventing  the  snap- 
ping of  the  constitutional  mainspring.  Neurasthenics  complain 
of  being  "  all  run  down,"  and  that  simply  means  that  they  were 
previously  "  all  wound  up."  (  Nervous  prostration  usually  cures 
—  it  never  kills. 


THE  HIGH  PRESSURE  LIFE  in 

We  recently  had  a  chronic  neurasthenic  with  blood-pressure 
running  from  85  to  90  mm.  He  finally  got  it  into  his  head  that 
he  was  going  to  get  well.  He  went  to  work  in  earnest  at  his 
simple  treatments  and  began  to  take  an  interest  in  the  world; 
he  actually  forgot  about  his  vague  sensations  and  wandering 
pains,  began  to  eat  heartily  and  sleep  well,  and  soon  he  was 
rapidly  gaining  in  weight.  In  the  meantime  his  blood-pressure 
had  slowly  and  gradually  climbed  up  to  120  mm.  —  practically 
normal,  while  his  distressing  morning  headaches  almost  entirely 
disappeared. 

Occasionally  we  meet  with  cases  of  abnormally  low  blood- 
pressure  which  are  difficult  to  diagnose.  There  seems  to  be  a 
constitutional  tendency  toward  low  tension,  just  as  in  other  cases 
we  observe  a  family  tendency  to  high  pressure. 

A  CASE  OF  RELIGIOUS  WORRY 

A  worried  city  missionary,  troubled  with  sleeplessness,  rap- 
idly losing  her  appetite,  also  losing  in  weight,  had  been  treated 
several  weeks  with  electricity  and  with  baths  for  stomach  and 
nervous  troubles.  Blood-pressure  remained  about  165.  Careful 
inquiry  elicited  the  fact  she  had  no  family  trouble,  no  church 
trouble,  in  fact,  she  seemed  to  be  free  from  everything  that 
would  lead  up  to  the  mental  states  of  fear  and  worry.  Further 
inquiry,  however,  disclosed  the  fact  that  she  worried  consider- 
ably over  the  subjects  of  her  missionary  endeavor.  At  first 
she  resented  our  efforts  to  admonish  her  on  this  point;  but  one 
day  she  was  told  the  story  of  the  simple-minded  boy,  who  in- 
sisted on  carrying  two  bushels  of  chop-feed  on  his  shoulders 
while  riding  horseback,  and  on  being  asked  why  he  did  so, 
replied:  "Well,  I  reckon  if  the  horse  can  carry  me  I  ought  to 
be  willing  to  carry  the  feed."  She  went  home  and  began  to 
think  matters  over,  finally  arriving  at  this  conclusion:  "If 
Christ's  death  on  the  cross  can't  save  sinners,  no  amount  of 
anxiety  or  worry  on  my  part  can  effect  their  salvation." 

She  appeared  at  the  office  on  the  following  day,  asserting 
that  she  had  got  a  new  brand  of  religion  —  a  faith  that  could 
free  her  from  useless  worry  and  unnecessary  anxiety.  She  af- 
firmed that  she  had  learned  the  meaning  of  such  Scriptures  as, 


H2  il  ORRY  AND  NERVOUSNESS 

"  Casting  all  your  care  upon  Him,  for  He  careth  for  you,"  and 
"  Come  unto  Me  all  ye  that  labor  and  are  heavy  laden,  and  I 
will  give  you  rest;"  and  strange  to  report,  the  taking  of  her 
blood-pressure  showed  that  it  had  fallen  to  140,  and  it  subse- 
quently went  down  to  about  135. 

Worry  and  anxiety  always  raise  the  blood-pressure  until  they 
result  in  bringing  on  nervous  prostration,  and  then  the  unfor- 
tunate victim  is  found  to  be  suffering  from  a  depressive  reac- 
tion—  neurotic  low  blood-pressure.  Disappointment,  grief,  and 
cankering  care,  all  conspire  together,  gradually  and  surely  to 
raise  the  blood-pressure.  Likewise  anger,  moral  condemnation, 
and  every  cause  of  restlessness  and  mental  dissatisfaction,  all 
serve  to  increase  arterial  tension  and  raise  the  pressure. 

The  fact  that  one  worries  over  a  good  cause  —  the  fact  that 
the  objects  of  your  anxious  solicitude  are  wholly  unselfish 
and  altruistic  —  in  no  wise  mitigates  the  inevitable  consequences 
of  the  increased  blood-pressure  and  other  indescribable  nerv- 
ous  complications  which  so  surely  follow  in  the  wake  of  all 
protracted  worry  and  long-sustained  anxiety. 

ALCOHOL    AND    DRUGS 

Domestic  infelicity  and  family  jars  all  conspire  to  raise  the 
blood-pressure,  increase  the  nervous  tension,  and,  indirectly, 
make  for  digestive  disturbances  and  nervous  breakdown.  We 
commonly  hear  such  statements  as  "  Family  trouble  drove  him 
to  drink."  In  all  such  cases,  in  our  opinion,  the  alcohol  is  taken 
largely  for  its  immediate  effect  in  lowering  the  blood-pressure 
and  thus  temporarily  relieving  the  intense  and  wrought-up  nerv- 
ous state.  While  the  continuous  use  of  alcohol  operates  to  raise 
the  blood-pressure  by  its  tendency  to  harden  the  arteries,  the 
effect  for  the  time  being  is  to  lower  the  pressure  and  thus 
relieve  the  oppressive  tension. 

Experience  has  taught  us  that  high  blood-pressure  often 
leads  its  victims  to  drink  and  drugs.  We  well  remember  the 
case  of  a  young  lawyer  who  came  to  the  office  begging  for 
morphine.  This  man  was  a  periodical  drinker:  and  when  we 
remonstrated  with  him  he  replied:  "Well,  doctor,  if  you  don't 
give  me  morphine  or  something  else  to  relieve  this  spell,  it "11 


THE  HIGH  PRESSURE  LIFE  113 

drive  me  to  the  saloon  for  whiskey.''  In  this  connection  it  should 
be  explained  that  morphine  does  lower  the  blood-pres- 
sure —  a  discovery  that  this  lawyer  is  not  alone  in  having  made. 
Indirectly,  then,  freedom  from  worry  and  anxiety  proves  to  be 
a  practical  aid  to  temperance,  in  that  faith  —  a  peaceful  frame 
of  mind  —  operates  to  prevent  high  tension,  with  its  accompany- 
ing tendency  and  temptation  to  resort  to  pressure-lowering  drugs 
such  as  alcohol  and  morphine. 

BLOOD-PRESSURE   AND  RELIGION 

Religion,  as  a  state  of  mind,  seems  to  exert  a  salutary  in- 
lluence  upon  the  blood-pressure.  In  all  cases  of  nervous  high 
tension  where  the  sufferer  seems  to  have  heartily  and  sincerely 
embraced  some  form  of  religious  belief  or  moral  faith,  the 
blood-pressure  almost  invariably  begins  to  come  down.  On  the 
other  hand,  in  case  the  acceptance  of  some  sort  of  religion 
leads  to  overscrupulous  anxiety  and  overconscientious  worry, 
the  blood-pressure  will  certainly  go  up.  It  makes  no  apparent 
difference  what  particular  brand  of  religion  is  embraced,  as  far 
as  the  blood-pressure  mechanism  is  concerned,  only  one  con- 
dition seems  to  be  requisite,  and  that  is  that  the  religion  must 
be  accepted  so  fully  and  sincerely  as  absolutely  to  deliver  the 
mind  from  the  torments  of  doubt  and  the  uncertainties  of  fear; 
actually  to  set  the  mind  at  rest  and  fill  the  thoughts  with  faith 
and  trust. 

APOPLEXY    AND    HEART    FAILURE 

The  practical  conclusion  of  the  blood-pressure  matter  is  sim- 
ply this:  If  the  arterial  tension  is  permitted  to  go  on  increas- 
ing from  month  to  month  and  from  year  to  year,  eventually  the 
danger  point  will  be  reached  (about  200  mm.),  and  then  it  is 
only  a  question  of  time  when  one  of  two  things  will  happen, 
either  the  heart-pump  will  give  out  —  the  valves  give  way  or 
the  muscle  dilate  —  or  the  arterial  hose  will  burst  at  some  weak- 
point,  usually  in  the  brain,  with  the  result  of  producing  apoplexy 
and  its  accompanying  paralysis.  Apoplexy,  paralysis,  and  heart 
failure  are  tremendously  on  the  increase,  and  the  strenuous 
living  —  the   life   of   anxiety,   overwork,   and   worry  —  is   now 


ii4  WORRY  AND  NERVOUSNESS 

generally  recognized  by  the  medical  profession  as  being  in  a 
large  measure  responsible  for  the  enormous  fatality  of  these 
heart  and  circulatory  disorders. 

Of  course  I  am  not  unmindful  of  the  fact  that  society  and 
civilization  are  the  gainers  in  many  ways,  as  a  result  of  this 
"'  speedy  "  and  "  tense  "  life  which  so  many  of  us  lead.  For, 
however  unfortunate  the  results  of  our  modern  "  high  tension  " 
upon  the  individual,  they  react,  in  some  degree  at  least,  to  the 
general  good  of  society  and  to  the  promotion  of  the  national 
welfare.  However  painful  the  condition  of  the  individual,  or 
complete  the  failure,  or  self-caused  the  misfortune;  one  may 
know  that,  in  part  at  least,  this  failure  is  a  portion  of  the  service 
which,  as  an  individual,  he  performs  for  the  good  of  the  whole. 
One  cause  of  his  failure  is  the  need  of  the  race  for  setting  high 
ideals,  and  striving  strenuously  to  attain  them.  He  suffers  that 
the  race  may  gain,  and  his  condition  itself  must  be  accepted  as 
a  contribution  to  the  welfare  of  the  race. 

WORRY  AND  ARTERIOSCLEROSIS 

Clapp  is  a  strong  believer  in  worry  as  a  cause  of  hardened 
arteries,  and  the  author  has  seen  many  cases  which  undoubtedly 
confirm  this  view.  Romberg  says :  "  Neurasthenia  is  a  cause 
of  arteriosclerosis,  because  of  frequent  alterations  of  blood- 
pressure  occasioned  by  the  unstable  and  excitable  nervous 
state."  Neurasthenia  is  also  one  of  the  most  fruitful  causes  of 
intestinal  indigestions  and  its  consequent  autointoxication,  even 
independently  of  overeating.  Autointoxication,  in  its  turn,  be- 
sides directly  producing  arteriosclerosis,  tends  to  produce  more 
neurasthenia  by  poisoning  the  nervous  system,  and  a  vicious 
circle  is  thus  established.  So  the  "  good  "  work  may  go  on  like 
the  operations  of  a  battledore  and  shuttlecock,  and  the  poor  vic- 
tim is  on  the  high  road  toward  future  trouble  with  his  arteries. 

The  fact  that  sooner  or  later  the  arteries  feel  the  wear  and 
tear  of  life  is  well  expressed  by  Osier  in  Modem  Medicine,  as 
follows : 

Among  organs  the  blood  vessels  alone  enjoy  no  rest.  Not  only 
does  a  ceaseless  rush  of  fluid  pass  through  them  at  a  speed  of  ten 


THE  HIGH  PRESSURE  LIFE  115 

feet  a  second,  but  the  walls  of  the  main  pipe  are  subjected  to  a  dis- 
tending force  of  2  1/5  pounds  to  a  square  inch  60  to  80  times  a 
minute;  80,000  to  100,000  times  in  the  24  hours.  The  heart  has  rest 
in  diastole,  but,  distended  by  the  charge  from  the  left  ventricle,  the 
arteries  pass  it  on,  partly  by  the  natural  elasticity  of  their  walls, 
partly  by  an  active  contraction  of  their  muscular  fibers.  Like  other 
organs,  they  live  under  two  great  laws  —  use  maintains  and  in  a 
measure  sustains  structure;  overuse  leads  to  degeneration;  in  time 
they  grow  old,  in  threescore  or  in  fourscore  years  the  limit  of  their 
endurance  is  reached,  and  they  wear  out. 

Regarding  the  effect  of  worry  (and  even  over-study)  on  the 
brain,  Clapp  says: 

Likewise  we  can  easily  believe  that  excessive  mental  work  may 
lead  to  arterial  degeneration,  and  here  I  want  to  protest  against 
the  silly  delusion  which  many  good  people  have  that  no  amount  of 
hard  mental  work  ever  hurts  anybody.  This  statement,  if  ques- 
tioned, is  apt  to  be  so  hedged  about  by  limitations,  such  as  providing 
there  is  sleep  enough  and  food  enough,  etc.,  that  its  force  is  prac- 
tically almost  emasculated.  School  teachers  especially  resort  to  this 
statement,  perhaps  in  order  to  stimulate  their  lazy  pupils.  If  any 
breakdown  occurs,  the  teacher  does  not  like  to  admit  that  it  is  from 
too  much  study,  but  lays  all  the  blame  on  dances,  parties,  and  social 
dissipation,  which,  of  course,  are  not  to  be  disregarded,  if  they  enter 
into  the  question.    This  is  not  always  the  case. 

BRAIN   WORK  AND  HARD  ARTERIES 

Now  we  know  that  people  differ  tremendously  in  their  ability  to 
work  their  brains ;  and  that  what  is  overwork  for  one  is  child's  play 
for  another;  and  that  we  all  have  our  limitations  beyond  which  we 
cannot  go  with  safety,  no  matter  how  many  hygienic  influences  we 
put  around  ourselves;  so  that  we  must  admit  that  at  least  some  of 
11s,  and  probably  most  of  us,  whether  we  actually  do  so  or  not,  can 
injure  ourselves  by  an  excess  of  pure  and  unadulterated  brain  work, 
even  if  we  faithfully  try  otherwise  not  to  break  nature's  laws.  From 
this  mental  overwork  alone  comes  a  certain  amount  of  the  wear  and 
tear  of  life,  which  knocks  the  elasticity  out  of  our  arteries  as  well  as 
out  of  our  steps  (if  it  lasts  long  enough)  and  which  makes  us  prema- 
turely old.  This  is  true  for  most  of  us,  and  it  is  no  just  criticism 
to  instance  on  the  other  side  a  few  men  like  Gladstone,  of  enormous 
powers  of  endurance,  both  mental  and  physical.  In  fairness  to  the 
other  side,  however,  we  are  forced  to  admit  that  much  of  what  is 


u6  WORRY  AXD  XERVOUSXESS 

called  mental  overwork  is  not  so  at  all,  but  only  a  moderate  or  proper 
amount  of  work,  plus  worry  or  other  depressing  emotions.  The  old 
proverb  that  "  worry  kills  more  than  hard  work "'  is  universally 
admitted  to  be  true,  and  very  often  the  men  that  worry  thus  kills, 
die  with  hardened  arteries.  They  are  often  among  our  most  honored 
and  valued  citizens,  and  are  cut  off  before  their  time  by  more  or  less 
intense  application  to  business  mixed  with  the  natural  worry  and 
anxiety  which  our  modern  strenuous  competition  and  the  desire  to 
get  rich  quickly  seem  almost  to  make  necessary,  especially  in  neu- 
rotics or  in  persons  of  nervous  temperament.  Without  this  terrible 
worry  in  most  cases  they  might  readily  stand  the  work.  With  the 
worry  they  are  apt  to  be  exhausted  by  sleepless  nights,  a  great  con- 
sumer of  the  bodily  energies,  by  neurasthenia,  and  by  interference 
with  the  proper  function  of  their  nutritive  or  trophic  nerves  in  rela- 
tion to  the  tissues  of  the  arterial  coats.  Their  worry  also  easily 
induces  the  oncoming  of  gout,  rheumatism,  Bright's  disease,  diabetes, 
etc.,  which  facilitate  the  advancing  arterial  degeneration,  especially  if 
they  have  a  hereditary  weak  streak  in  that  direction.  Such  men,  in 
such  dilemmas,  are  strongly  tempted  to  overstimulate  with  alcohol. 
If  they  were  anxious  for  any  assistance  in  helping  them  along  the 
unhappy  road  on  whicli  they  were  already  speeding  they  could  not  do 
better  than  apply  this  agency.  In  such  cases,  if  they  die,  it  is  not 
really  at  bottom  the  worry  that  kills. 

"'  AMERICANITIS  " 

The  general  public  are  waking  up  to  the  fact  that  this  in- 
ordinate "  hustle  "'  and  "  rush  "  have  something  to  do  with  our 
increased  tendency  to  nervousness.  The  following  editorial  ap- 
peared some  time  since  in  a  Chicago  daily  paper,  under  the 
caption  "  Why  Americans  Succeed  " : 

It  is  largely  a  question  of  pressure.  The  nations  of  Europe,  and 
especially  the  English,  wonder  at  the  success  of  the  American  people. 
If  any  Englishman  wants  to  know  why  the  American  race  can  beat 
the  English  race  in  the  struggle  for  industrial  precedence,  let  him 
stand  on  one  of  the  downtown  platforms  of  the  Illinois  Central  Rail- 
road in  Chicago  from  seven  until  nine  in  the  morning  as  the  suburban 
trains  come  in. 

Far  outside  of  the  station  the  train  appears,  puffing  and  panting, 
and  while  it  is  still  going  at  dangerous  speed,  men,  young  and  old, 
are  seen  leaning  far  out  from  every  platform. 

As  the  train  rushes  in.  the  men  leap  from  the  cars  and  a  wild  rush 


Fig.  6.  The   Results   of   "  High   Speed  "   on   Man   and   Machine 
Engine  Trouble,  the  Result  of  "  High  Speeding  "  ;  Engine 
Trouble,  the  Result  of  "  His:h  Living  " 


THE  HIGH  PRESSURE  EIFE  117 

follows  for  the  business  district.  Not  a  man  is  walking  slowly  and 
deliberately.  It  is  one  rush  to  business;  it  is  one  rush  all  day;  it  is 
one  rush  home  again. 

The  gauge  on  the  engine  tells  the  pressure  of  steam  and  the  work 
that  the  engine  can  do.  The  gauge  on  the  American  human  being 
stands  at  high  pressure  all  the  time.  His  brain  is  constantly  excited ; 
his  machinery  is  working  with  a  full  head  of  steam. 

Tissues  are  burned  up  rapidly,  and  the  machine  often  burns  up 
sooner  than  it  should.  The  man  bald  and  gray  in  his  youth,  the  man 
a  victim  of  dyspepsia,  of  nervousness,  of  narcotics  and  stimulants,  is 
a  distinct  American  institution.  He  is  an  engine  burned  out  before 
his  time;  but  his  work  has  been  done,  and  that  great  locomotive 
works,  the  American  mother,  is  forever  supplying  the  demand  for 
new  engines  to  be  run  at  dangerously  high  speed. 

The  American  succeeds  because  he  is  under  high  pressure  always ; 
because  he  is  determined  to  make  speed,  even  at  the  risk  of  bursting 
the  boiler  and  wrecking  the  machine.     (Fig.  6.) 

RESULTS  OF   HIGH   BLOOD-PRESSURE 

1.  Arteriosclerosis.  High  blood-pressure  is  one  of  the  recog- 
nized causes  of  arteriosclerosis  —  degeneration  and  hardening 
of  the  arteries  —  and  arteriosclerosis  is  the  real  cause  of  old 
age,  or  senile  degeneration. 

2.  Apoplexy.  Since  high  blood-pressure  is  one  of  the  causes 
of  hardening  of  the  arteries,  it  then  becomes  apparent  that  it 
is  the  indirect  cause  of  apoplexy,  for  this  is  merely  a  rupture 
of  the  small  arteries  of  the  brain,  which  are  unable  to  stand 
the  enormous  pressure  required  in  order  to  force  the  blood 
through  the  stiff  and  shrunken  vessels. 

3.  Bright's  Disease.  This  is  a  condition  in  which  the  arteries 
of  the  kidney  are  shrivelling  up  as  the  result  of  poisons  and 
high-pressure.  This  disease,  with  its  attendant  evils  of  dropsy 
and  heart  failure,  is  also  largely  attributable  to  high-pressure 
influences. 

4.  Heart  Failure.  It  must  be  apparent  that  if  the  blood-pres- 
sure is  to  be  constantly  increased,  in  order  to  nourish  the  body 
and  overcome  the  growing  resistance  of  the  hardening  arteries, 
the  heart  —  the  great  blood  pump  —  will  be  called  upon  to  exert 
increased  force ;  and  this  it  does,  by  hypertrophy,  until  by  and 
by  the  walls  are  overstretched,  the  heart  becomes  permanently 


u8  HORRY  AND  NERVOUSNESS 

dilated,  and  when  the  end  comes,  it  is  called  "  heart  failure." 
Six  times  more  people  die  in  New  York  from  heart  failure  than 
from  typhoid  fever. 

Certain  mental  diseases  are  also  indirectly  produced  or  in- 
fluenced by  high  or  low  blood-pressure,  such  as  mania,  melan- 
cholia, etc.,  as  well  as  ordinary  nervousness,  sleeplessness,  and 
many  common,  everyday  maladies. 

When  the  heart  and  blood  vessels  are  able  long  to  stand  the 
strain,  and  when  the  individual  is  predisposed  to  "  nervous- 
ness," then  takes  place  the  expected  "  blow  up  "  or  "  break- 
down," and  the  blood-pressure  quickly  tumbles  down  to  normal 
—  usually  below  normal  —  and  the  patient  complains  bitterly 
of  feeling  "  all  run  down."  etc.  This  is  the  "  secondary  low 
pressure,"  of  neurasthenia  and  will  persist  until  the  nervous 
tone  of  the  entire  system  is  restored. 

Remedial  measures  adapted  to  the  regulation  of  blood-pres- 
sure will  be  fully  considered  in  later  chapters  devoted  to  the 
treatment  of  the  neurasthenic  states. 

MMAKY    OF    THE    CHAPTER 

1.  While  twentieth  century  "  strenuousness  "  undoubtedly 
contributes  something  to  our  modern  high  tension,  it  is  rather 
strenuous  living  and  not  strenuous  working  that  is  responsible 
for  so  many  nervous  "  breakdowns." 

2.  The  average  blood-pressure  of  a  normal  adult  ranges  from 
no  to  130  mm.  High  pressure  is  associated  with  headaches, 
arteriosclerosis,  apoplexy,  heart  failure  and  Bright's  disease; 
while  low  blood-pressure  usually  accompanies  neurasthenia. 

3.  Moderately  high  blood-pressure  invigorates  and  exhilarates, 
while  abnormally  low  pressure  weakens  and  debilitates,  and  con- 
stitutes a  temptation  to  resort  to  artificial  "  toning  up  "  pro- 
cedures. 

4.  Fear,  worry,  and  all  their  psychic  cousins  have  power  to 
raise  blood-pres'sure,  while  faith  and  trustfulness  exert  an 
influence  towards  normalizing  the  pressure. 

5.  Certain  drugs,  such  as  morphine,  alcohol,  the  bromides,  a 
host  of  headache  powders  and  other  pain  relievers,  are  but  tem- 
porary and  deceptive  blood-pressure  lowerers. 

6.  In  the  case  of  a  worried  ex-convict  with  a  blood-pressure 
of  190,  promised  immunity  from  arrest  reduced  the  pressure  in 
twenty- four  hours  to  155. 

7.  It  is  not  uncommon  to  observe  a  blood-pressure  fluctuation 


THE  HIGH  PRESSURE  LIFE  n9 

of  from  25  to  50  mm.  in  the  case  of  certain  highly  emotional  and 
semi-hysterical  individuals. 

8.  High  blood-pressure  due  to  psychic  causes  may  be  almost 
immediately  cured  by  a  cessation  of  worry;  the  low  pressure  of 
neurasthenia  may  likewise  be  helped  upward  by  a  change  in  the 
mental  state. 

9.  Nervous  prostration  is  Nature's  way  of  preventing  certain 
high  strung  nervous  people  from  actually  "  blowing  up.-'  Nerv- 
ous prostration  usually  cures  —  it  never  kills. 

10.  The  fact  that  the  object  of  one's  worry  is  highly  com- 
mendable—  as  in  the  case  of  missionary  worry  —  in  no  wise 
detracts  from  its  pernicious  influence  in  elevating  blood- 
pressure. 

n.  Disappointment,  grief,  and  cankering  care,  like  anger  and 
an  accusing  conscience,  all  conspire  together  gradually  and 
surely  to  raise  the  blood-pressure. 

12.  Domestic  infelicity  and  business  troubles  unfailingly  tend 
to  raise  blood-pressure,  and  their  victims  are  "  driven  to  drink  " 
because  of  the  fact  that  alcohol  temporarily  lowers  pressure  — 
in  the  end  it  tends  to  raise  the  pressure. 

13.  Religion,  when  devoutly  experienced,  seems  to  exert  a 
salutary  influence  upon  all  cases  of  high  blood-pressure  due  to 
worry  and  anxiety. 

14.  When  blood-pressure  is  allowed  to  go  up  to  the  neighbor- 
hood of  200  mm.  there  is  grave  danger  of  heart  failure  on  the  one 
hand  and  apoplexy  on  the  other. 

15.  We  are  compelled  to  recognize  that  while  the  individual 
may  be  a  loser  as  a  result  of  our  modern  "  tense  "  and  "  speedy  " 
modes  of  life,  that  society  as  a  whole  reaps  many  benefits  there- 
from. 

16.  Worry,  sorrow,  and  even  excessive  mental  work  are  now 
looked  upon  as  contributing  directly  to  the  production  of  arterio- 
sclerosis. 

17.  While  overstudy  is  admittedly  a  cause  of  premature  old 
age,  nevertheless,  unhygienic  physical  practices  are  also  usually 
found  among  the  real  causes. 

18.  High  tension  and  arterial  degeneration  as  a  rule  result 
from  overworry,  overwork,  overeating,  and  overdrinking. 

19.  "  Americanitis "  is  a  term  coined  to  include  all  of  the 
mental  and  physical  mal-practices  whose  combined  influence 
tends  to  raise  the  blood-pressure,  deplete  the  vitality,  and  break 
down  the  nervous  energies. 

20.  The  results  of  long  continued  high  blood-pressure  are 
headaches,  arterio-sclerosis,  apoplexy  and  heart  failure.  High 
tension  is  also  associated  with  Bright's  disease  and  other  physical 
disorders. 


CHAPTER  X 
NEURASTHENOIDIA,  OR  XEAR-XEURASTHEXIA 

IN  THE  beginning  of  our  study  of  the  neurasthenic  states 
proper,  we  must  lay  clown  the  principle  that  all  these  neu- 
rotic conditions  rest  upon  a  definite  hereditary  base,  and  are 
specifically  due  to  some  form  of  abnormal  brain  working  or 
nervous  functionating. 

Brain  control  may  be  defined  as  a  faculty  which  is  inherent 
in  men  and  women  who  arc  in  a  normal  state  of  health.  When 
we  speak  of  normal  brain  control  we  mean  that  every  idea, 
impression,  or  sensation  is  controlled  by  reason,  judgment, 
and  will.  It  is  easy  to  imagine  the  state  of  one  who  lacks  this 
controlling  power;  his  uncontrolled  brain  would  without  this 
regulating  power,  be  practically  in  a  state  of  psychic  anarchy, 
a  helpless  victim  and  an  easy  prey  to  every  impulse,  emotion, 
and  passing  fear;  quite  unable  to  reason  sanely  and  soberly. 
Such  an  individual  is  doomed  to  a  life  of  sorrow  and  neuras- 
thenic suffering.  Entire  lack  of  brain  control  is  exceptional; 
what  we  find  more  frequently  among  neurasthenic  persons  is 
a  sort  of  unstable  or  insufficient  control.  Three  forms  of  ennui 
or  neurasthenoidia  may  be  recognized,  vis.,  the  hereditary,  the 
acquired,  and  the  accidental  forms. 

The  patient  will  judge  and  reason  in  a  normal  way  respecting 
many  things,  while  at  the  same  time  he  is  peculiarly  dominated 
by  certain  ideas  and  impulses  which  he  himself  recognizes  as 
quite  absurd  or  greatly  exaggerated,  and  over  which  his  will  has 
little  or  no  power  of  control;  this  is  the  neurasthenoidic  state. 
This  same  mental  state  carried  one  step  further  results  in  the 
typical  neurasthenic  state  with  all  its  accompanying  physical 
manifestations,  bodily  symptoms,  and  psychic  tortures. 

120 


XEURASTHEXOIDIA  121 

EFFECTS    OF    INSUFFICIENT    ERAIN    CONTROL 

The  phenomena  of  instability  of  control  are  in  the  main  the 
same  in  neurasthenoidia  as  in  out-and-out  neurasthenia.  The 
sufferer's  state  of  mind  and  health  is  constantly  changing  from 
good  to  bad,  and  going  from  bad  to  worse,  and  all  this  takes 
place  without  the  slightest  evident  reasons.  These  changes  re- 
cur from  time  to  time;  a  frivolous  mood  may,  for  example,  be 
succeeded  by  a  marked  fit  of  depression. 

Let  us  now  see  what  are  the  effects  of  this  insufficient  brain 
or  mind  control  on  the  ideas,  emotions,  and  actions.  Even  in 
those  cases  where  the  insufficiency  of  control  is  very  slight, 
a  definite  and  marked  discomfort  will  be  caused  the  patient  by 
the  feeling  or  conviction  that  he  is  not  fully  cognizant  of  all 
the  ideas  hatching  out  in  or  passing  through  his  brain.  He  will 
often  be  troubled  and  harassed  by  a  vague  feeling  that  he  is 
only  about  one-half  awake,  that  his  mind  is  getting  away  from 
him  —  that  he  cannot  escape  from  the  half-drowsy  state  of 
mind  which  ever  and  anon  threatens  to  creep  over  him.  Help- 
less —  he  is  carried  by  this  uncertainty  out  on  the  sea  of  fear. 

If  this  insufficiency  is  more  developed,  the  symptoms  increase 
proportionately;  he  no  longer  suffers  from  a  vague  feeling  of 
discomfort,  but  from  a  sensation  of  painful  and  distracting 
confusion,  a  veritable  whirl  of  disjointed  and  uncontrolled 
ideas. 

These  uncontrolled  ideas  are  usually  found  to  be  unconnected 
and  indefinite.  They  may  be  repeated  indefinitely,  or  may  be- 
come so  fixed  in  the  mind  as  to  possess  the  power  to  torture 
the  patient  quite  independent  of  will  control.  The  chief  defects 
in  the  thinking  of  these  neurasthenoidic  patients  are  exagger- 
ation or  deformation  of  their  ideas  and  emotions ;  also  a  woeful 
lack  of  preciseness  and  clearness.  The  resultant  bodily  actions 
have  the  same  marked  defects.  They  are  indeterminate,  hesi- 
tating, and  frequently  executed,  apparently,  while  in  a  semi- 
conscious or  dreamy  state  of  mind. 

The  patient  is  only  vaguely  aware  of  the  results  of  all  this 
insufficient  control  over  his  ideas,  emotions,  and  actions ;  he 
dimly  recognizes  the  consequences  of  his  demoralized  mental 
actions  without  realizing  that  thev  constitute  the  origin  of  the 


[22  WORRY  AND  NERVOUSNESS 

majority    of    the    most    distressing    symptoms    of    his    unique 
affliction. 

ENNUI    AND    NEURASTHENOIDIA 

Thousands  of  well-to-do  people  are  suffering  from  the  accu- 
mulated results  of  intellectual  inactivity  and  physical  idleness. 
They  have  become  the  victims  of  a  sort  of  refined  laziness  — 
a  conventional  stagnation  of  mind  and  a  fashionable  inaction  of 
body. 

One  reason  many  poor  people  are  relatively  happier  than  the 
rich,  is  that  they  still  have  so  many  things  to  seek  for;  and 
eagerness  is  one  of  the  most  forceful  and  uplifting  attributes 
of  human  mental  action.  Possession  not  infrequently  spoils  the 
pleasures  experienced  while  pursuing  the  coveted  treasure. 

While  much  of  the  neurasthenia  of  the  poor  may  result  from 
the  hereditary  predisposition  plus  the  stress  and  strain  and 
worry  of  poverty;  it  must  be  admitted  that  the  neurasthenoidia 
of  the  rich  springs  from  the  same  hereditary  taint  plus  the  ennui 
of  mental  indolence  and  physical  idleness. 

I  was  recently  consulted  by  a  woman  who,  when  writing  to 
make  the  appointment,  said  in  her  letter  that  she  "was  living 
a  life  which  had  become  unbearable,"  and  that  she  ''must  have 
speedy  relief  or  else  go  mad."  This  patient  when  she  arrived 
was  found  to  be  in  excellent  —  almost  perfect  physical  con- 
dition, even  the  blood-pressure  was  120  —  normal.  The  only 
possible  physical  complaint  she  was  entitled  to  make  was 
that,  possibly,  she  did  not  sleep  soundly. 

This  woman  had  a  devoted  husband,  two  splendid  children, 
a  luxurious  home  —  with  motors,  horses,  and  servants  —  in  fact, 
everything  that  money  could  buy,  and  yet  she  began  her  history 
by  saying:  "To  me.  life  is  not  worth  living.  I  am  thirty-eight 
years  old,  and  I  feel  that  it  is  useless  to  live  longer." 

She  seemed  to  have  lost  all  interest  in  everybody  and  every- 
thing—  not  excepting  her  own  family.  She  said  religion  no 
longer  appealed  to  her,  that  reading  was  distasteful,  and  that 
her  husband  had  "  become  a  perfect  bore."  She  appealed  to  me 
to  know  if  she  was  really  going  crazy,  and  if  I  thought  not, 
then  about  how  long  would  she  live  and  have  to  endure  "  this 


NEURASTHENOIDIA  123 

exquisite  torture  of  living  in  a  world  where  nothing  fascinates 
you,  nobody  enthrals  you,  and  everybody  and  everything  bores 


BREAKING  THE  SPELL 

This  good  woman  presented  a  typical  case  of  neurasthenoidia. 
She  lacked  many  of  the  symptoms  of  a  typical  neurasthenia, 
but  she  had  every  earmark  of  typical  ennui  —  neurasthenoidia. 
If  she  is  not  promptly  rescued  from  the  mildew  of  her  inaction 
and  from  the  maze  of  her  selfish  indolence,  she  is  on  the  high 
road  to  full  fledged  and  unmistakable  neurasthenia  —  genuine 
and  unadulterated  nervous  invalidism. 

Now,  how  did  I  talk  to  this  patient?  What  did  we  try  to  do 
for  her?  The  very  first  thing  I  endeavored  to  do  was  to  dis- 
abuse her  mind  of  the  thought  that  she  was  "  sick."  I  fully 
and  carefully  explained  that  ennui  and  even  fully  developed 
neurasthenoidia  were  not  real  "  diseases  "  in  the  sense  she  un- 
derstood—  that  her  condition  was  largely  the  result  of  neurotic 
heredity,  luxurious  environment,  faulty  education,  lack  of  train- 
ing, and  more  in  particular  a  loss  of  the  sense  of  one's  personal 
responsibility  to  the  world.  Of  course,  I  did  not  neglect  to  show 
how  all  this  had  come  about  from  her  false  ideas  of  happiness 
and  how  they  were  obtained  from  idleness  and  inaction  on  the 
one  hand ;  and  a  gradual  weakening  and  almost  complete  loss 
of  will  power  on  the  other.  She  strongly  resented  my  state- 
ment that  she  had  "  come  to  me  in  quest  of  some  new  secret 
or  source  of  happiness"  —  and  greatly  objected,  at  first,  to  my 
diagnosis  that  "  narrow-minded  selfishness  was  at  the  bottom 
of  all  her  afflictions."' 

It  was  only  after  a  pointed,  spirited,  and  searching  appeal 
that  she  confessed  to  the  sordid  motives  which  had  actuated 
her  life  from  its  earliest  years,  and  then,  after  unburdening 
her  soul  —  after  bringing  forth  a  series  of  confessions  long  sup- 
pressed—  confessions  of  failure  in  her  duties  as  a  mother,  a 
wife,  a  neighbor,  and  as  a  woman,  I  say  that  it  was  not  until 
after  this  awakening  that  we  were  able  to  begin  that  long  and 
tedious  educational  process  which  promises  to  effect  deliverance 
of  the  soul  from  its  lone  and  dreary  prison  house  of  self. 


124  WORRY  AND  NERVOUSNESS 

LIBERATION    OF   THE  SOUL 

Not  all  cases  of  submerged  personality  and  imprisoned  soul 
can  be  dealt  with  alike,  but  the  following  summary  of  my  meth- 
ods will  be  found  adapted  to  the  average  case. 

1.  I  give  careful  and  conscientious  attention  to  any  real,  bona 
fide  physical  condition  which  may  demand  treatment;  taking 
care  not  to  allow  the  patients  to  receive  any  unnecessary  at- 
tention or  treatment  which  would  tend  to  dignify  the  thought 
that  they  were  suffering  from  some  real  disease. 

2.  I  try  to  show  them  what  real  happiness  is  —  and  how  it  is 
obtained.  I  point  out  the  unhappiness  of  selfishness  and  the 
happiness  of  unselfishness.  I  make  plain  that  to  increase  one's 
wants  is  to  decrease  one's  happiness ;  while  to  decrease  the  wants 
means  to  increase  the  capacity  for  happiness. 

3.  The  demand  is  imperative  that  the  patient  go  to  work  im- 
mediately. "  Get  a  job "  is  the  first  curative  slogan  in  the 
therapeutic  battle  with  ennui.  You  must  get  hold  of  a  definite 
aim  in  life.  You  must  work  and  think  and  plan  to  this  one 
great  end.  Then  you  will  not  find  yourself  "bored"  if  you  are 
left  alone  with  yourself  now  and  then  —  when  you  are  momen- 
tarily deprived  of  something  to  entertain,  occupy,  or  amuse  you. 

4.  You  must  learn  to  think  less  about  yourself  and  more 
about  other  people  —  the  world.  Begin  at  once  to  bestow  upon 
your  family  and  neighbors  the  great  love  you  have  so  long  lav- 
ished and  squandered  upon  your  miserable  and  unhappy  self. 
The  more  you  love  yourself  —  the  more  your  misery;  the  more 
you  love  others  —  the  happier  you  are. 

What  have  you  ever  done  to  make  some  one  else  happy? 
I  do  not  want  to  hear  about  "  giving  in  to  my  husband,"  the 
charity  ball,  or  a  check  to  the  Salvation  Army.  Such  gifts  — 
which  cost  you  little  or  nothing  —  may  indeed  benefit  the  recip- 
ient, but  they  do  little  good  to  the  donor.  Go  right  out  in  the 
great  wide  world  and  personally  and  actually  do  something  for 
some  really  needy  and  stricken  soul,  and  you  will  be  thrilled  and 
exhilarated  with  a  new  satisfaction  —  a  new  brand  of  pleasure 
and  happiness  —  which  all  your  former  and  perfunctory  "  char- 
ity "  acts  never  approached. 

5.  Get  into  the  game  of  life  with  your  husband  (if  you  are 


NEURASTHEXOIDIA  125 

a  married  woman).  In  every  crisis  of  his  life  stand  with  him 
shoulder  to  shoulder  on  the  firing  line.  This  is  an  experience 
which  develops  that  domestic  patriotism,  family  loyalty,  and 
that  superb  comradeship  which  makes  husband  and  wife  one  — ■ 
and  which  effectively  destroys  that  silly  bugaboo  of  "  bore- 
dom "  so  frequently  felt  by  you  when  in  the  presence  of,  and 
when  so  annoyed  by  the  trifling  eccentricities  of  your  companion. 

6.  If  love  cannot  budge  you,  if  affection  does  not  draw  you 
forth  and  away  from  yourself,  then  let  duty  push  you  —  lit- 
erally shove  you  out  —  into  the  world  to  begin  the  activities 
which  shall  fulfill  the  divine  destiny  ordained  for  you,  while 
your  soul  is  filled  to  overflowing  with  the  satisfaction  and  con- 
sciousness of  having  "  done  your  best"  —  "having  done  your 
duty."  Build  a  hospital.  Get  a  law  passed  against  child  labor. 
Do  something  to  improve  the  condition  of  the  present  genera- 
tion, or  to  increase  the  prospects  for  happiness  in  the  next  gen- 
eration. Find  a  hundred  other  idle  sufferers  like  yourself  and 
organize  a  movement  which  shall  contribute  to  the  solution  of 
some  world  problem.  Do  something  worth  while ;  don't  feebly 
push  along  some  trifling  and  sentimental  pseudo-reform  propa- 
ganda. Don't  simply  join  an  anti-vivisection  society  or  some 
other  useless  and  harmful  movement.  Seek  out  a  woman's  job 
—  or  a  man's  job  —  and  take  hold  of  it  with  a  determined  will. 

7.  Then,  after  you  have  learned  how  to  work,  after  you  are 
initiated  into  the  joy  and  satisfaction  of  productive  labor,  you 
may  find  an  entry  into  the  joys  of  play  and  the  pleasures  of 
well  earned  recreation.  Yes,  I  know  you  are  about  to  say  that 
all  this  advice  would  have  been  all  right  fifteen  or  twenty  years 
ago,  that  it  is  too  late  to  remedy  things  now.  But  I  also  know 
that  it  is  not  too  late.  I  know  you  can  do  it  now  if  you  will 
set  about  it  with  resolution  and  perseverance.  Breathe  upon 
the  smouldering  fires  of  your  sleeping  ambition  and  see  if  the 
flames  will  not  kindle  and  burn  with  such  fervor  that  your  dor- 
mant soul  will  be  warmed  into  action  and  your  mind  inspired 
to  exertion. 

The  further  treatment,  physical,  mental,  and  moral,  of  ennui 
or   neurasthenoidia,   will    more   appropriately   be   presented   in 


126  WORRY  AXD  NERVOUSNESS 

succeeding  chapters  in  connection  with  neurasthenia  proper,  and 
will  not,  therefore,  be  further  taken  up  in  this  chapter.  Xeu- 
rasthenoidia  is  merely  the  vestibule  to  the  fully  developed  nerv- 
ous prostration,  and  is  given  separate  attention  here  because  of 
the  fact  that  a  large  number  of  sufferers  seem  never  to  pro- 
gress much  beyond  this  phase,  or  else  they  so  long  linger  in  this 
pre-typical  neurasthenic  state  as  to  deserve  specific  remedial 
suggestions. 

SUMMARY    OF    THE    CHAPTER 

1.  Brain  control  is  the  secret  of  sound  nervous  health.  Lack 
of  brain  control  plus  hereditary  pre-disposition  means  neuras- 
thenoidia  —  psychic  anarchy. 

2.  We  recognize  three  classes  of  ennui  or  neurasthenoidia  — 
the  hereditary,  the  acquired,  and  the  accidental. 

3.  Lack  of  brain  control  in  its  earlier  stages  is  characterized 
by  mental  uneasiness,  nervous  discomfort,  distracting  confusion, 
fixed  and  disjointed  ideas.  Meeting  memory,  and  the  constantly 
recurring  feeling  that  one  is  only  about  half  awake. 

4.  The  chief  mental  characteristics  of  neurasthenoidia  are 
exaggeration  of  the  emotions,  deformation  of  ideas,  a  deranged 
sense  of  proportions,  together  with  a  woeful  lack  of  preciseness 
and  clearness. 

5.  The  chief  bodily  symptoms  of  neurasthenoidia  are  general 
physical  indisposition,  muscular  weakness,  undue  hesitation  and 
halting  in  the  execution  of  physical  movements,  resembling  one's 
conduct  in  a  semi-conscious  or  dreamy  state. 

6.  Neurasthenoidia  and  ennui  are  frequently  the  result  of 
intellectual  inactivity,  physical  idleness,  moral  indolence,  and 
social  laziness  —  a  general  stagnation  of  mind,  body  and  soul 
powers. 

7.  Some  pathetic  victims  of  ennui  are  so  bored  by  everybody 
and  dissatisfied  with  everything  simply  because  they  are  wholly 
self-centered  —  wickedly  selfish. 

8.  In  order  to  cure  such  patients  it  is  necessary  to  point  out 
the  acting  causes  of  their  difficulty,  viz :  neurotic'heredity,  lux- 
urious environment,  continuous  idleness,  faulty  education  and 
the  loss  of  the  sense  of  one's  personal  responsibility  to  the  world. 

9.  In  liberating  these  victims  of  fashionable  ennui,  it  is 
necessary  to  recognize  and  properly  treat  any  accompanying 
physical  disease  or  disorder. 

10.  The  neurasthenoidic  must  be  taught  the  unhappiness  of 
selfishness  and  the  happiness  of  unselfishness  —  that  to  increase 
one's  wants  is  to  decrease  one's  happiness  and  vice  versa. 


NEURASTHENOIDIA  127 

11.  It  is  imperative  that  these  patients  go  to  work  —  "get  a 
job."    They  must  acquire  a  definite  and  continuous  aim  in  life. 

12.  Xeurasthenoidics  must  cease  to  think  of  themselves  and 
enlist  in  the  thrilling  and  exhilarating  business  of  making  other 
people  happy. 

13.  If  love  cannot  persuade  the  victims  of  ennui  to  begin 
action,  then  let  a  sense  of  duty  drive  them  into  the  "  game  of 
life." 

14.  We  have  seen  many  of  these  victims  of  inaction  speedily 
cured  by  enlisting  in  some  local  crusade  or  joining  a  national 
movement,  such  as  building  a  hospital,  child  labor,  votes  for 
women,  etc.,  etc. 

15.  It  is  never  too  late  to  mend,  never  too  late  to  breathe  upon 
the  smouldering  fires  of  sleeping  ambition,  and  thus  to  warm 
and  arouse  dormant  soul  powers  to  creative  action. 


CHAPTER  XI 
NEURASTHENIA,   OR   NERVOUS   EXHAUSTION 

IN  THE  last  analysis,  neurasthenia  must  be  regarded  as 
a  state  of  accumulated  chronic  nervous  fatigue.  The  lit- 
eral meaning  of  the  term  is  "  nerve  weakness."  And  so  it  would 
appear  that  all  of  us  are  to  some  extent  more  or  less  neuras- 
thenic —  especially  at  such  times  as  we  may  chance  to  be  a  trifle 
overworried  or  slightly  overworked.  It  should  hardly  be  looked 
upon  as  "  up-to-date  "  to  tell  a  patient  he  was  suffering  from 
"  nervous  weakness  "  —  in  fact  it  would  be  apt  unduly  to  alarm 
him,  but  he  takes  very  kindly  and  naturally  to  having  his  ail- 
ment diagnosed  as  "  neurasthenia." 

NEURASTHENIA    DEFINED 

I  prefer  to  confine  the  use  of  the  term  neurasthenia  to  those 
states  of  habitual  nervous  fatigue  due  to  multiple  functional 
causes.  The  various  phobias,  obsessions,  fixed  ideas,  and  other 
morbid  impulses  are  extra-neurasthenic  manifestations,  and  al- 
though they  may  be  —  in  fact  usually  are  —  accompanied  by 
more  or  less  neurasthenia,  nevertheless  I  prefer  to  look  upon 
such  nervous  disturbances  as  separate  and  apart  from  neuras- 
thenia;  and  that  is  just  what  has  been  done  in  this  work,  having 
already  fully  considered  many  of  these  insistent  mental  moods 
in  former  chapters,  while  a  few  remain  for  later  treatment. 

From  the  standpoint  of  prognosis,  many  of  these  morbid 
nervous  states  so  closely  related  to  and  so  commonly  associated 
with  neurasthenia  may  or  may  not  be  as  serious  as  the  neuras- 
thenia proper  —  depending  entirely  on  their  severity  as  well  as 
on  the  strength  of  the  individual's  nervous  system. 

The  general  nervousness  which  is  so  often  associated  with 
various  organic  diseases  such  as  tuberculosis,  the  infections  such 
as  influenza,  or  with  such  painful  local  disorders  as  gastric  ulcer 

128 


XEURASTHEXIA  OR  NERVOUS  EXHAUSTIOX   129 

or  cystitis,  should  not  be  looked  upon  as  neurasthenia.  If  there 
is  a  real  neurasthenic  state  present  in  such  cases  it  should  cer- 
tainly be  regarded  as  secondary  to  the  other  and  pre-existent 
disorder.  If.  however,  after  the  other  disease  or  disorder  is 
recovered  from  the  "  nervousness  "  still  persists,  then,  but  not 
until  then,  may  we  recognize  this  neurotic  state  as  one  of  true 
neurasthenia. 

NEURASTHENIA    NOT    A    DISEASE 

It  must  early  be  made  clear  to  the  reader  that  neurasthenia 
is  not  a  disease  —  that  is,  not  a  circumscribed,  well  denned 
disease  such  as  spinal  sclerosis  or  epilepsy.  It  is  not  even  a 
disease  in  the  sense  that  hysteria  might  be  so  considered.  It  is 
entirely  true  that  many  hysteric  and  even  melancholic  patients 
are  also  in  some  degree  neurasthenic;  but  in  the  majority  of 
these  cases  the  neurasthenia  must  be  looked  upon  as  being  more 
or  less  superficial,  while  the  major  disorder  is  deep-rooted  and 
far  more  grave. 

We  must,  then,  come  to  look  upon  neurasthenia  as  a  func- 
tional nervous  disorder,  not  dependent  on  any  organic  disease 
and  not  associated  with  hysteria  or  any  other  definite  mental 
disorder.  Neurasthenia  is  always  characterized  by  great  nerv- 
ous irritability,  disproportionate  mental  and  nervous  fatigue, 
and  accompanied  by  a  vast  assortment  of  unpleasant  sensations 
and  other  symptoms  in  the  head  and  various  other  parts  of  the 
body. 

And  so  we  find  today  that  many  of  the  leading  neurologists 
of  the  world  deny  that  neurasthenia  is  a  distinct  disease.  They 
look  upon  neurasthenia  as  being  merely  a  "  symptom  complex  " 
—  an  aggregation  of  nervous  symptoms  characterized  by  the 
extravagant  expenditure  of  nervous  energy.  This  premature 
dissipation  of  nerve  energy  may  be  voluntary  —  as  in  the  am- 
bitious pursuit  of  riches  and  fame ;  or  involuntary  as  in  the  bat- 
tle with  disease,  disappointment,  and  inhospitable  surroundings. 
And  so  again  we  reiterate  that  neurasthenia  is  not  a  disease  in 
the  sense  that  tuberculosis  and  Bright's  disease  are  diseases. 

It  is.  no  doubt,  due  to  this  generally  accepted  idea  that  neu- 
rasthenia is  a  specific  disease,  that  another  and  erroneous  idea 


130  WORRY  AND  NERVOUSNESS 

has  gained  general  acceptance  in  the  popular  mind,  viz. :  that 
the  one  great  cause  of  present-day  neurasthenia  is  the  strenuous 
life  of  the  American  people.  While,  as  noted  in  a  former  chap- 
ter, the  strenuousness  of  our  modern  business  and  industrial 
life  may  be,  to  some  extent,  responsible  for  much  of  our  ex- 
hausting high  tension  and  the  resultant  neurasthenic  collapse, 
nevertheless,  as  also  previously  pointed  out,  we  are  forced  to 
recognize  the  fact  that  numerous  other  influences  are  at  work 
as  causative  factors  in  the  production  of  nervous  prostration. 
The  chief  of  all  of  these  contributing  causes  is  an  inherited 
neurotic  taint,  chronic  worry,  together  with  a  host  of  minor 
violations  of  the  laws  of  mental  hygiene  and  healthful  living. 

ARE  WE  ALL  NEURASTHENIC? 

Xot  infrequently  we  have  a  nervous  patient  ask  us  if  we  are 
not  "  all  more  or  less  neurasthenic,"  and,  of  course,  I  am  forced 
to  acknowledge  that  we  are  "  all  a  bit  neurasthenic  at  times.*' 
Neurasthenics  are  all  highly  impressionable  —  unduly  sensitive; 
indeed,  they  are  merely  exaggerated  cases  of  what  would  other- 
wise be  looked  upon  as  being  perfectly  normal. 

Professor  Speyr  of  Berne  once  said:  "  It  is  only  the  neuras- 
thenics who  do  anything  in  this  world."  He  undoubtedly  meant 
that  the  indolence  and  indifference  which  so  often  passes  for 
healthy  nervous  equilibrium  is  a  false  show  of  power;  while  the 
enormous  capacity  for  enthusiastic  expression  which  is  so  ever- 
present  in  the  case  of  the  near-neurasthenic,  would  be.  if  prop- 
erly controlled,  a  tremendous  power  for  good  in  the  performance 
of  useful  work. 

CLASSIFICATION  OF  NEURASTHENIA 

Neurasthenia  has  been  variously  classified  by  different  writers. 
One  authority  giv;:  the  following: 

i.  Essential  or  hereditary  neurasthenia.  This  form  of  nerv- 
ousness usually  begins  in  early  youth  and  steadily  increases  — 
with  slight  remissions  —  until  it  becomes  chronic,  generally  in 
middle  life.  (The  author  is  inclined  to  regard  most  of  these 
early  appearing  or  hereditary  neurasthenias  as  cases  of  psychas- 
thenias.     See  chapter  xvn.) 


NEURASTHENIA  OR  NERVOUS  EXHAUSTION    131 

2.  Accidental  or  acquired  neurasthenia.  In  this  form  the 
onset  is  abrupt.  The  patient  who  has  previously  appeared  to 
be  in  splendid  health,  is  suddenly  and  without  warning  stricken 
down  with  nervous  prostration.  Many  of  these  cases  are  pros- 
trated over  night  or  else  within  a  comparatively  short  space  of 
time.  This  form  of  neurasthenia  does  not  advance  progressively. 
The  most  typically  marked  and  acutely  painful  symptoms  make 
their  fullfledged  appearance  at  the  very  beginning.  This  is  the 
form  of  nervous  prostration  which  more  frequently  strikes  one 
down  as  a  result  of  some  mental  shock  or  physical  strain  which 
was  suddenly  precipitated :  or  in  other  and  rarer  instances  may 
be  due  to  a  continuous  and  intensified  period  of  overwork  and 
over-worry. 

3.  Intermittent  neurasthenia.  In  this  type  of  nervous  dis- 
order the  onset  is  also  rather  sudden  but  without  apparent  cause. 
The  condition  of  the  sufferer  progresses  unfavorably  and  within 
a  few  weeks  becomes  apparently  serious,  and  may  thus  con- 
tinue for  some  weeks  or  even  months;  when  suddenly,  after  the 
same  inexplicable  manner  that  characterized  the  onset,  he  feels 
decidedly  improved  or  even  completely  cured,  arises  from  his 
bed  and  is  able  almost  immediately  to  resume  his  ordinary  daily 
duties.  This  period  of  improvement  and  apparent  good  health 
lasts,  as  a  rule,  for  some  months  or  even  years,  whereupon,  a 
new  attack  of  nervous  prostration  descends  upon  the  patient 
preceded  by  few  or  no  premonitory  symptoms.  This  is  the 
so-called  "  periodic  form  of  neurasthenia."  the  attacks  occur- 
ring every  two  or  three  years  and.  in  some  cases,  where  the 
stress  and  strain  is  more  severe,  coming  on  as  frequently  as  once 
or  twice  a  year. 

One  authority,  who  lays  so  much  stress  on  "  brain  control." 
seems  to  regard  these  three  forms  of  neurasthenia  as  merely 
indicating  three  different  degrees  of  cerebral  control.     He  says : 

These  three  forms,  which  are  so  dissimilar  in  their  causes,  their 
beginnings  and  their  course  do  not  differ  materially  if  they  are 
examined  from  the  point  of  view  of  defect  of  brain  control.  In  the 
essential  form  (hereditary)  we  have  to  deal  with  a  case  of  arrested 
development  of  this  faculty,  whereas  in  the  other  forms  it  is  a  ques- 
tion of  the  instability  of  this  control;  the  three  forms  are  in  reality 


i32  WORRY  AXD  NERVOUSNESS 

only  three  degrees  of  insufficiency.  As  regards  the  prognosis,  it  is 
natural  that  the  check  in  development  of  brain  control  should  render 
a  cure  more  difficult.  It  is  no  longer  a  question  of  the  instability  of 
this  control;  the  three  forms  are  in  reality  only  three  degrees  of 
insufficiency. 

Instability  of  the  intermittent  form  should  be  easy  to  correct,  but 
here  we  have  to  contend  with  another  factor,  in  that  the  sufferer  only 
submits  with  difficulty  to  strict  treatment,  as  he  already  knows  that 
he  will  again  feel  well  without  any  effort  on  his  part ;  it  is  true  that 
this  feeling  of  good  health  is  very  artificial,  as  a  relapse  is  inevitable. 

THE    PHYSIOLOGY    OF     NEURASTHENIA 

The  significant  thing  about  neurasthenics  is  the  fact  that  they 
suffer  inordinately  from  an  unusually  large  number  of  emotional 
disturbances.  Situations  that  would  not  be  noticed  by  the  average 
normal  person  are  able  greatly  to  annoy,  grieve,  or  frighten  the 
neurasthenic. 

It  would  seem  that  the  brain  centers  in  the  cortex  of  the 
cerebrum  of  neurasthenics  had  become  unusually  and  abnormally 
sensitised  to  the  recognition  of  certain  sensations  and  ideas,  so 
that  these  influences,  in  the  place  of  arousing  a  normal  response 
and  reaction,  are  able  to  excite  and  turn  loose  an  outgoing  flood 
of  nerve  currents  which  sweep  over  the  body  —  taking  every- 
thing by  storm  —  literally  demoralizing  every  function  of  the 
entire  organism.  This  oversensitive  condition  of  the  nervals 
mechanism  is  identical  with  that  condition  we  have  elsewhere 
described  as  a  "  lowering  of  the  emotional  threshold." 

Dubois  has  compared  the  almost  incurable  hereditary  nervous 
invalids  to  "  spiritless  horses,"  and  so  whether  we  are  dealing 
with  the  victims  of  a  true  neurasthenia  or  with  the  less  rebellious 
sufferers  from  intermittent  neurasthenia,  we  shall  find  almost 
invariably  that  our  cardinal  psychic  symptoms  are  pusillanimity, 
discouragement,  a  tendency  to  worry,  and  the  absence  of  self- 
mastery. 

THE    MECHANISM    OF   EMOTIONS 

Pershing,  in  summing  up  the  James-Lange  theory  of  emotions, 
offers  the  following  comment : 


XEURASTHEXIA  OR  XERVOUS  EXHAUSTIOX   133 

The  significance  of  this  aspect  of  neurasthenia  becomes  clear  when 
it  is  viewed  in  the  light  of  the  James-Lange  theory  of  the  emotions. 
Observation  and  reflection  extending  over  many  years  have  con- 
vinced me  that,  for  the  practical  neurologist,  it  is  a  true  theory, 
although  the  pure  psychologist  may  be  doubtful  about  some  of  its 
implications.  According  to  this  theory  every  emotion  consists  of 
three  processes  whose  order  is  invariable. 

1.  The  occurrence  of  the  exciting  perception  or  idea. 

2.  An  action  of  the  brain,  excited  by  this  perception  or  idea,  which 
sends  efferent  nerve-currents  to  the  organs  throughout  the  body, 
causing  a  change  in  the  action  of  the  organs. 

3.  The  return  of  sensory  nerve-currents  from  the  disturbed  organs 
to  the  sensory  areas  of  the  cortex,  causing  a  change  in  the  sensations 
and  a  consequent  perception  of  the  bodily  disturbance. 

Take  as  a  simple  example  the  case  of  a  person  startled  by  sudden 
noise.  The  first  stage  is  simply  the  perception  of  the  sound;  the 
second  is  the  jerking  of  voluntary  muscles,  the  involuntary  cry.  the 
sudden  catch  in  the  breath,  and  the  jump  of  the  heart;  the  third  is 
the  disagreeable  sensations  caused  by  these  sudden  changes  in  the 
body.  In  such  cases  the  bodily  effects  and  consequent  unpleasant 
sensations  are  generally  greatly  in  excess  of  what  one  would  expect 
from  the  loudness  of  the  sound.  They  may  sometimes  be  useful  in 
enabling  one  to  escape  from  a  sudden  danger,  but  are  generally  quite 
useless,  and  their  exhausting  effect  is  far  greater,  the  duration  of 
activity  being  considered,  than  that  of  any  kind  of  work  whatever. 
So  it  is  with  the  various  phases  of  anger,  grief  and  fear  in  the  neu- 
rasthenic. The  exciting  idea  is  generally  not  such  as  one  would 
expect  to  have  a  marked  effect,  but  it  starts  an  emotional  process 
whose  second  stage  involves,  directly  or  indirectly,  every  muscle- 
fiber  and  gland  in  the  body,  changing  motion,  respiration,  circulation, 
and  secretion,  while  the  third  stage  includes  bad  feelings  which 
further  alarm  and  depress. 

Biologically,  this  disproportion  of  effect  to  apparent  cause  is 
explainable  by  the  fact  that  the  emotions  are  largely  identical  with 
the  preservative  and  protective  instincts,  for  which  there  is  a  prede- 
veloped  inherited  mechanism,  which  normally  in  case  of  danger  causes 
prompt  and  vigorous  action  toward  escape,  defense,  or  attack,  with- 
out waiting  for  reason  to  give  its  sanction.  In  modern  life  this 
mechanism  is  seldom  useful,  while  its  needless  action,  if  frequently 
repeated,  is  always  harmful.  It  is  this  primitive,  inherited,  powerful 
reflex  mechanism  which  has  become  oversensitive  and  excessively 
active  in  neurasthenia. 


i34  WORRY  AND  NERVOUSNESS 

DIAGNOSTIC    DELUSIONS 

As  carelessly  used  by  the  laity  —  and  even  by  some  physi- 
cians—  the  word  neurasthenia,  like  the  term  rheumatism,  has 
been  made  to  cover  a  vast  realm  of  diagnostic  ignorance  or 
indolence.  It  seems  to  have  become  the  rule  of  many  persons 
and  not  a  few  physicians  to  diagnose  all  "  tired  feelings  "  as 
neurasthenia,  and  all  "  achy  feelings"  as  rheumatism  (especially 
if  they  are  worse  on  rainy  days  >. 

The  real  truth  is  that  neither  neurasthenia  nor  rheumatism 
are  bona  fide  diseases  but  merely  symptoms  —  sort  of  barometric 
indicators  — of  the  general  state  of  the  organism;  the  neuras- 
thenic symptoms  indicating  the  state  of  nervous  strength  and 
control,  and  rheumatism  indicating  the  presence  of  poisonous 
toxins  derived  from  some  foci  of  infection  in  the  body. 

In  every  case  when  the  patient's  "  presenting  symptom  "  is 
tired  feelings  it  is  the  physician's  duty,  before  making  a  diagnosis 
of  neurasthenia,  thoroughly  to  overhaul  the  patient,  and  thus  be 
reasonably  certain  that  he  i<  not  overlooking  some  obscure  or- 
ganic disease  or  other  pathological  condition  which  may  underlie 
these  nervous  symptoms,  and  which  is  wholly  responsible  for 
their  manifestation. 

NEURASTHENIA    CONFOUNDED    WITH     MELANCHOLIA 

It  is  a  serious  mistake  to  diagnose  true  melancholia  as  neuras- 
thenia. There  is  a  two-fold  harm  in  such  a  mistaken  diagnosis. 
First,  if  the  melancholic  is  diagnosed  neurasthenic,  he  will  not  be 
properly  watched,  and,  as  it  is  a  well  known  fact  that  true 
melancholies  all  have  more  or  less  suicidal  tendencies  he  may, 
during  an  extra  bad  fit  of  depression,  make  away  with  himself. 
In  the  second  place,  great  harm  is  done  to  every  neurasthenic 
who  may  know  of  or  subsequently  hear  of,  this  mistaken  diag- 
nosis in  that  it  has  become  a  matter  of  record  that  Air.  So  and 
So  —  diagnosed  a  neurasthenic  —  has  committed  suicide  and  so 
the  fear-ridden  and  worry-tortured  neurasthenes  straightway 
begin  to  nourish  and  coddle  the  new  and  added  fear  that  they 
also  may  some  time  commit  suicide.  It  is  a  fact  that  neuras- 
thenics practically  never  commit  suicide,  but  cases  of  mistaken 
diagnosis  as  between  melancholia  and  neurasthenia  are  so  com- 


NEURASTHENIA  OR  NERVOUS  EXHAUSTION    135 

mon  as  to  lead  large  numbers  of  neurasthenic  sufferers  to  live  in 
constant  fear  and  dread  of  committing  suicide. 

NEURASTHENIA    AND    THE    AGED 

We  must  also  be  very  careful  how  we  diagnose  neurasthenia 
in  old  people.  It  is  hardly  likely  that  individuals  who  have 
escaped  nervous  breakdown  throughout  the  changing  vicissitudes 
of  early  life  and  their  adult  careers  will  be  found  to  succumb  to 
any  ordinary  stress  or  strain  which  may  overtake  them  in  ad- 
vanced years.  It  has  been  my  experience  that  most  cases  diag- 
nosed neurasthenia  in  elderly  people  have  turned  out  to  be 
premature  arteriosclerosis.  In  the  beginning  of  a  rapid  onset 
of  arterial  degeneration,  there  are  likely  to  appear  many  symp- 
toms closely  resembling  those  of  neurasthenia.  Careful  and 
repeated  observation  of  the  blood-pressure  will  obviate  the  dan- 
ger of  such  mistaken  diagnoses. 

bright's  disease  and  diabetes 

Likewise,  there  is  great  danger  of  mistaking  a  slowly  devel- 
oping case  of  Bright's  disease  for  neurasthenia.  We  have  had 
many  cases  sent  to  us  with  the  diagnosis  of  "  nervousness  "  — 
especially  men  from  thirty-five  to  forty-five  years  of  age  — 
whose  urine  showed  on  examination  both  casts  and  albumen. 
We  should  be  very  careful  about  settling  upon  a  diagnosis  of 
neurasthenia  in  the  cases  of  middle-aged  men  who  have  never 
had  nervous  prostration,  and  who  gradually  begin  to  develop 
slight  but  persistent  headaches,  tired  feelings  on  waking  up  in 
the  morning  —  especially  if  this  inordinate  fatigue  persists  until 
night  —  together  with  more  or  less  stomach  trouble  and  occa- 
sional tendency  to  diarrhoea.  An  examination  of  the  blood- 
pressure  and  the  urine  of  such  supposedly  neurasthenic  men  will 
almost  invariably  disclose  the  fact  that  they  have  been  suffering 
for  years  from  Bright's  disease.  It  is  possible  for  such  patients 
to  pass  along  until  within  two  weeks  of  death  and  present  no 
more  serious  symptoms  than  those  ordinarily  exhibited  by 
chronic  neurasthenic  sufferers. 

At  the  very  time  of  this  writing  there   came  to  the   office 


136  WORRY  AND  NERVOUSNESS 

a  man  forty-two  years  of  age,  who  had  suffered  almost  con- 
stantly from  slight  headaches  for  the  past  seven  years.  His 
case  had  been  diagnosed  as  one  of  "  over  work,"  and  he  had 
been  advised  to  take  a  good  long  vacation  —  spend  a  few  weeks 
in  Florida  or  California.  A  routine  physical  examination  of 
this  patient  disclosed  absolutely  nothing  that  was  wrong  —  noth- 
ing but  what  could  be  reasonably  ascribed  to  "  nervousness  " 
—  until  the  blood-pressure  was  taken  which  registered  180,  and 
then  an  examination  of  the  urine,  which  was  loaded  with  casts 
and  albumen,  made  it  necessary  quickly  to  change  the  diagnosis 
from  an  innocent  and  harmless  neurasthenia  to  that  of  nephritis 
or  beginning  Bright's  disease.  Further  study  of  this  case  dis- 
closed the  presence  of  a  chronically  ulcerated  tooth,  the  removal 
of  which  led  to  an  immediate  improvement  in  the  patient's 
symptoms. 

Another  disease  that  is  mistaken  for  neurasthenia  in  its  earlier 
stages  is  diabetes.  We  find  many  patients  who  have  undoubtedly 
been  passing  sugar  in  the  urine  for  some  time,  but  whose  feel- 
ings of  muscular  weariness  and  general  physical  indisposition 
have  been  credited  up  to  a  carelessly  diagnosed  neurasthenia. 

NEURASTHENIA    AND    CHRONIC    WORRY 

In  considering. mistakes  in  diagnosis,  attention  should  also 
be  called  to  the  fact  that  many  patients  are  diagnosed  as  neuras- 
thenic who  are  merely  suffering  from  an  acute  attack  of  "  over 
attention "  —  simply  an  exacerbation  of  their  habitual  mental 
state  of  chronic  worry  —  or  maybe  they  have  merely  focalized 
all  their  attention  on  the  transitory  symptoms  of  some  passing 
functional  ailment  of  some  internal  organ. 

It  is  exceedingly  unfortunate  for  the  future  happiness  and 
welfare  of  such  victims  of  chronic  worry  and  near-neurasthenia 
to  have  their  nervous  ailments  dignified  with  a  diagnosis  of  full 
fledged  neurasthenia.  I  have  found  that  such  patients  insist 
on  having  a  name  by  which  to  call  their  nervous  disorders,  and 
not  wishing  to  label  them  for  the  rest  of  their  life  as  neuras- 
thenics, I  have  been  literally  forced  to  clinically  create  a  special 
grouping  for  such  patients  and  call  their  milder  nervous  condi- 
tion by  the  term  previously  defined  —  neurasthenoidia. 


NEURASTHENIA  OR  NERVOUS  EXHAUSTION   137 

THE    PENALTY    OF    IGNORANCE 

The  intensity  of  the  neurasthenic's  sufferings  is  not  always 
measured  by  the  intensity  of  the  sensation  he  experiences  or  the 
pain  he  is  called  upon  to  endure;  but  rather  is  the  keenness  of 
his  misery  gauged  by  the  intensity  of  his  dread  —  the  acuteness 
of  his  fear  and  the  measure  of  his  anxiety  —  all  of  which  arise 
directly  and  wholly  from  his  ignorance,  from  his  lack  of  under- 
standing regarding  the  source  and  significance  of  these  con- 
stantly recurring  sensations  and  symptoms  in  various  parts  of 
his  body. 

After  the  neurasthenic  has  thus  been  blown  about  by  the  winds 
of  emotion  and  driven  before  the  tempest  of  misunderstood  and 
misinterpreted  feelings  for  months  or  years  —  after  having 
exhausted  all  the  orthodox  remedies  and  methods  of  treatment 
—  it  is  little  wonder  that  he  goes  in  quest  of  some  new  and 
"  royal  road  to  health  "  method  of  getting  well,  as  Courtney 
says: 

At  this  point  he  is  almost  certain  either  to  yield  to  the  lure  of  some 
patent  medicine  advertisement  or  take  up  with  a  religio-medical  cult 
which  offers  to  lead  him  unerringly  along  the  road  he  is  so  anxious  to 
travel.  If  he  chooses  the  "mind  and  soul"  course,  his  vocabulary 
soon  enlarges  through  taking  in  such  amazing  terms  as :  autosugges- 
tion, psychotherapy,  psychotherapeutics,  sublimial  mind,  sub-conscious 
mind,  and  others  equally  polysyllabic.  And,  at  the  same  time,  he  is 
very  apt  to  become  deluded  with  the  notion  that  Mind  is  the  master 
and  that  the  body  is  its  abject  slave. 

BEHAVIOR  OF  THE  NERVOUS   SYSTEM 

Now,  if  these  nervous  sufferers  were  given  an  intelligent 
insight  into  the  physiology  and  anatomy  of  the  nervous  system, 
and  if  it  were  made  perfectly  clear  to  them  just  what  happens 
when  the  functions  of  the  human  nervous  system  are  disturbed 
and  distorted,  as  in  the  case  of  neurasthenia,  then  the  veil  of 
mystery  and  ignorance  which  ordinarily  enshrouds  the  subject 
of  nervous  prostration  would  be  finally  lifted,  the  mists  would 
roll  away,  and  this  in  and  of  itself  would  largely  affect  the  cure 
of  the  larger  part  of  the  neurasthenic's  sufferings  and  sorrows. 


138  il  ORRY  AND  NERVOUSNESS 

Concerning  the  physical  properties  of  nerves  and  their  ten- 
dency to  suffer  in  varying  degrees  one  writer  has  said : 

The  important  fact  to  be  borne  in  mind  is  that  the  resistive  powers 
of  the  different  elements  which  make  up  the  nervous  system  vary  in 
degree  with  the  nature  of  the  functions  these  elements  are  designed 
to  perform.  For  example,  the  motor  nerves,  so  called,  which  have 
to  do  with  voluntary  action,  are  less  susceptible  to  the  influence  of 
vitality-depleting  agents  than  the  sensory  —  upon  which  we  depend 
for  feeling;  while  the  latter  are  superior,  in  respect  to  their  resistive 
powers,  to  the  great  sympathetic  which,  through  its  many  ramifica- 
tions and  connections,  is  largely  concerned  in  the  so-called  automatic 
functions  of  the  body  — such  as  respiration,  circulation,  digestion, 
and  so  forth.  Given  this  fact,  it  is  easy  to  understand  why,  in  states 
of  nervous  exhaustion,  the  bulk  of  the  physical  symptoms  should 
come  from  those  organs  over  which  the  sympathetic  holds  sway. 

The  nervous  system  has  truly  been  termed  the  master-tissue 
of  the  body,  and  in  the  case  of  neurasthenia  it  may  be  rightly 
regarded  as  the  tyrant  of  the  body.  Its  great  possibilities  for 
good,  when  the  individual  loses  control  over  the  nerve  centers, 
are  immediately  perverted  into  possibilities  for  evil. 

In  all  cases  of  neurasthenic  nervous  derangement  there  are 
never  to  be  found  any  demonstrable  changes  in  the  nerve  cell> 
or  structure  of  the  brain,  spinal  cord,  or  nerve  tracts.  That 
which  we  do  find  is  purely  functional.  The  delicate  balance  — 
that  fine  adjustment  between  mind  and  matter  —  is  temporarily 
deranged  or  destroyed  and  this  results  in  turning  loose  a  veri- 
table riot  of  impulses  and  sensations  often  resulting  in  such 
a  derangement  in  normal  function  as  to  turn  the  natural  work- 
ings of  the  nervous  system  into  a  "  diabolic  caricature  of  the 
normal." 

The  neurasthenic  sufferer  is  told  time  and  again  that  there 
is  nothing  organically  wrong  with  him,  he  has  swallowed  pre- 
scription after  prescription  containing  nerve  tonics  or  nerve 
sedatives,  and  it  is  no  wonder  that  deep  seated  discouragement 
begins  to  settle  down  over  his  disturbed  and  distracted  mind. 
It  would  seem  that  modern  medicine  has  done  almost  every- 
thing   imaginable    for   the   neurasthene    except   the   one    thing 


NEURASTHENIA  OR  KERVOUS  EXHAUSTION   139 

essential  to  his  cure  —  methodic  training  and  discipline  in  mind 
control  and  self-mastery. 

SYMPTOMS  OF  NEURASTHENIA 

In  this  place  we  will  give  but  a  brief  outline  of  the  symptoms 
of  neurasthenia,  as  the  varied  manifestations  of  this  interesting 
disorder  are  fully  presented  in  a  chapter  to  follow. 

While  it  is  true  that  neurasthenia  is  not  a  distinct  and  definite 
disease  entity,  nevertheless,  when  reduced  to  its  characteristic 
symptoms  it  forms  a  clinical  picture  quite  as  definite  as  that  of 
hysteria,  and  even  more  distinct  and  circumscribed  than  its 
near  and  more  largely  hereditary  cousin  —  psychasthenia. 

In  brief,  the  neurasthenic  state  is  characterized  by  widely 
distributed  and  exceedingly  diverse  groups  of  subjective  symp- 
toms among  which  predominate  those  typical  sensations  of  mus- 
cular fatigue  (real  and  not  imaginary)  nervous  exhaustion  and 
general  incapacity  for  effort  in  the  physical,  mental  and  moral 
domains. 

While  the  neurasthenic  presents  a  host  of  minor  and  ever- 
changing  complaints,  his  chief  and  constant  overshadowing 
difficulty  consists  in  his  peculiar  mental  state  of  psychic  depres- 
sion, hypochondriac  pre-occupations,  and  more  or  less  of  a 
melancholic  disposition. 

Chief  among  the  minor  symptoms  of  which  the  patient  com- 
plains will  be  found  a  series  of  functional  disturbances  and  dis- 
orders embracing  headache,  backache,  insomnia,  dyspepsia  and 
constipation,  not  to  mention  a  host  of  sensory  troubles  and 
annoying  symptoms  due  to  functional  disturbances  in  the  various 
organs  of  special  sense. 

FIVE  SORTS  OF  NEURASTHENIA 

While  there  may  be  some  advantage  in  the  classification  of 
neurasthenias  noted  in  the  early  part  of  this  chapter,  never- 
theless, I  prefer  to  classify  these  nervous  states  according  to  the 
clinical  grouping  and  predominance  of  the  symptoms.  This 
seems  to  me  the  wholly  proper  thing  to  do,  inasmuch  as  we  are 
compelled  to  regard  neurasthenia  as  a  clinical  disorder  and  not 
as  a  distinct  disease.    In  harmony  with  this  view,  therefore,  we 


140  WORRY  AND  NERVOUSNESS 

may  conveniently  designate  five  clinical  forms  of  neurasthenia 
as  follows : 

i.  Cerebral  neurasthenia. 

2.  Spinal  neurasthenia. 

3.  Gastric  neurasthenia. 

4.  Sexual  neurasthenia. 

5.  Traumatic  neurasthenia. 

The  further  discussion  of  these  special  forms  will  be  reserved 
for  another  chapter.     (Chapter  xvi.) 

SUMMARY    OF    THE    CHAPTER 

1.  Neurasthenia  must  be  regarded  as  a  state  of  accumulated 
chronic  nervous  fatigue  due  to  multiple  functional  causes.  It  is 
not  a  disease  in  the  sense  that  tuberculosis  is  a  disease. 

2.  The  various  chronic  worries,  phobias,  obsessions,  fixed  ideas 
and  other  morbid  impulses  should  not  be  confused  and  con- 
founded with  neurasthenia. 

3.  The  general  nervousness  accompanying  organic  diseases 
and  associated  with  local  painful  disorders,  should  not  prema- 
turely be  diagnosed  neurasthenia. 

4.  Neurasthenia  is  a  functional  nervous  disorder,  not  depend- 
ent on  any  organic  disease  and  not  associated  with  any  definite 
nervous  disorder  or  known  mental  disease. 

5.  Neurasthenia  is  merely  a  "  symptom  complex,"  character- 
ized by  the  extravagant  expenditure  of  mental  energy  and  its 
resultant  nervous  irritability,  inordinate  fatigue,  and  a  host  of 
other  unpleasant  nervous  symptoms  and  physical  sensations. 

6.  Modern  "  strenuousness  "  and  nervous  "  high  tension  "  are 
not  the  sole  causes  of  neurasthenia.  Other  and  equally  important 
factors  are  an  inherited  neurotic  taint,  chronic  worry,  together 
with  a  host  of  violations  of  the  laws  of  mental  and  physical 
hygiene. 

7.  We  are  all  a  bit  neurasthenic  at  times ;  that  is,  we  are  prone 
to  overexaggeration  of  symptoms,  overrecognition  of  sensations, 
and  overestimation  of  situations. 

8.  On  the  other  hand,  intellectual  ennui,  physical  indolence 
and  social  inertia  must  not  be  falsely  mistaken  for  healthy  nerv- 
ous equilibrium  and  exemplary  self-control. 

9.  Some  authorities  classify  neurasthenia  into  three  forms: 
(1)  essential  or  hereditary,  (2)  accidental,  or  acquired,  and  (3) 
intermittent. 

10.  The  hereditary  form  is  characterized  by  appearance  in 
the  early  years  of  life.    The  acquired  form  by  abrupt  onset  later 


NEURASTHENIA  OR  NERVOUS  EXHAUSTION    141 

on  in  life.     The  intermittent  form  by  unexpected  appearances 
and  frequent  return  attacks. 

11.  Some  authorities  contend  that  these  three  forms  of  neu- 
rasthenia merely  typify  three  different  degrees  of  brain  control 
—  or  lack  of  control. 

12.  Common  everyday  sensations  and  ordinary  emotional  dis- 
turbances which  are  passed  unnoticed  by  a  normal  individual, 
in  the  neurasthenic  are  able,  owing  to  a  lowering  of  the  emo- 
tional threshold,  to  throw  the  entire  organism  into  a  functional 
panic. 

13.  This  tendency  on  the  part  of  the  neurasthenic  to  allow 
trifling  causes  to  produce  such  disproportionate  reflex  effects  is 
but  a  reversion  to  that  reflex  barbaric  mechanism  designed  for 
self-protection  in  the  face  of  sudden  and  unexpected  danger. 

14.  It  is  this  primitive,  inherited  and  powerful  biological  reflex 
mechanism  which  has  become  so  highly  oversensitive  and  ex- 
cessively active  in  neurasthenia. 

15.  It  is  a  grave  error  in  neuralogical  diagnosis  to  classify  all 
"  tired  feelings  "  as  neurasthenia.  A  similar  blunder  is  made  in 
calling  all  *'  achy  feelings  "  rheumatism. 

16.  A  patient's  "  tired  feelings  "  should  never  be  diagnosed 
neurasthenia  until  a  thoroughgoing  examination  has  excluded 
every  possible  physical  cause  for  such  nervous  exhaustion. 

17.  It  is  unpardonable  to  confound  neurasthenia  with  true 
melancholia.  Such  mistakes  cause  neurasthenics  unnecessarily 
to  fear  suicide  and  other  things  common  to  melancholia,  but  not 
characteristic  of  the  neurasthene. 

18.  The  majority  of  cases  of  socalled  neurasthenia  in  old  peo- 
ple turn  out  to  be  the  early  symptoms  of  arterio-sclerosis. 

19.  Bright's  disease  and  diabetes  in  their  earlier  stages  are 
frequently  mistakenly  diagnosed  neurasthenia. 

20.  Headaches,  tired  feelings  persisting  all  day  and  into  the 
evening,  high  blood-pressure  and  an  occasional  diarrhoea  all 
point  to  probable  kidney  trouble.  Examine  the  urine  before 
diagnosing  as  neurasthenia. 

21.  On  the  other  hand,  it  is  a  serious  blunder  to  diagnose  acute 
attacks  of  overworry  or  overconcentration  of  the  mind  on  some 
bodily  function  as  a  bona  fide  case  of  neurasthenia. 

22.  The  intensity  of  a  neurasthenic's  miseries  are  determined 
not  by  the  intensity  of  his  sufferings,  but  rather  by  the  keenness 
of  his  dread  and  the  acuteness  of  his  anxiety  and  fears. 

21.  After  supposedly  exhausting  the  orthodox  remedies  and 
methods,  the  neurasthenic  goes  in  quest  of  some  "  royal  road  to 
health  " —  patent  medicines,  quack  doctors  or  one  of  the  numer- 
ous religio-medical  cults  of  the  day. 

24.  The  first  step  in  the  cure  of  neurasthenics  is  to  lift  the 


142  WORRY  AND  NERVOUSNESS 

veil  of  mystery  and  ignorance  which  enshrouds  the  subject  of 
nervous  prostration  —  teach  them  the  physiological  facts  con- 
cerning the  functions  and  control  of  the  nervous  system. 

25.  The  neurasthenic  must  recognize  that  the  larger  part  of 
his  distressing  symptoms  arise  in  those  organs  presided  over  by 
the  sympathetic  nervous  system. 

26.  The  tone  of  the  sympathetic  system  can  be  improved  to 
keep  pace  with  the  rising  tone  oi  the  cerebro-spinal  system.  In 
this  way  increased  voluntary  control  retiexly  strengthens  the 
involuntary  sympathetic  mechanism. 

27.  Neurasthenia  is  merely  a  temporary  disturbance  in  the 
delicate  balance  and  fine  adjustment  between  mind  and  matter. 
There  can  be  found  no  demonstrable  changes  in  the  nerve 
structures. 

28.  And  so  the  neurasthenic  is  assured  of  his  organic  sound- 
ness, jollied  up.  drugged,  and  in  many  other  ways  treated  all  to 
the  neglect  of  acquiring  the  one  thing  essential  —  self-mastery. 

29.  The  chief  symptoms  of  neurasthenia  are  sensations  of 
fatigue,  nervous  weakness,  and  general  incapacity  for  physical, 
mental  and  moral  effort. 

30.  The  leading  local  complaints  are  headache,  backache, 
insomnia,  digestive  difficulties,  and  functional  disturbances  of 
the  organs  of  special  sense. 

31.  Clinically  considered  there  are  five  forms  of  neurasthenia, 
viz.:   cerebral,' spinal,  gastric,  sexual,  and  traumatic. 


CHAPTER  XII 

THE  CAUSES  OF  NEURASTHENIA 

THE  causes  of  our  modern  high  tension  and  neurasthenic 
tendencies  are  indeed  manifold.  They  include  many 
mental,  physical,  social,  toxic,  and  other  "  habit  "  causes,  in  addi- 
tion to  our  proverbial  "  strenuousness." 

I.    HEREDITARY   PREDISPOSITION 

As  noted  in  a  former  chapter,  heredity  plays  an  important 
role  in  these  various  nervous  disorders.  I  do  not  look  upon 
neurasthenia  as  an  inherited  disease,  I  do  not  even  look  upon 
it  as  a  distinct  disease.  I  do  recognize  that  the  nervous  tendency 
to  "  break  down  "  and  "  blow  up  "  under  certain  provocation  and 
pressure,  is  a  truly  inherited  predisposition.  But  I  regard  the 
neurasthenic  state  or  disorder  as  an  acquisition,  not  as  an 
inheritance.  On  the  other  hand,  and  in  contrast  with  this 
position,  I  look  upon  psychasthenia  as  an  inheritance,  not  an 
acquisition. 

The  fact  that  neurasthenia  is  not  inherited  —  as  such  —  ex- 
plains why  it  so  seldom  manifests  itself  until  maturity  —  in 
adult  life,  while  psychasthenia  almost  invariably  shows  signs 
of  activity  even  before  the  period  of  adolescence.  We  have 
spoken  of  hereditary  and  acquired  neurasthenia.  Nowadays, 
the  tendency  is  to  classify  all  the  so-called  inherited  neuras- 
thenia as  psychasthenia.  And  so,  when  the  nervous  stress 
passes  beyond  the  limit  of  the  normal  or  average  endurance  and 
there  results  a  disorder  or  disease,  while  many  causes  may  be 
found,  usually  there  is  a  traceable  heredity  taint,  or  other  tem- 
peramental basis,  in  addition  to  a  history  of  long  continued 
stress  or  unhygienic  mental  life,  sometimes  resulting  from  some 
unfortunate  early  experience,  a  wrong  ideal,  or  an  abnormal 
emotion ;    and.    finally,    some    culminating    circumstance    which 

143 


i44  WORRY  AND  NERV0USX11SS 

appears  as  the  determining  shock,  the  last  straw  that  breaks  the 
camel's  back,  and  which  is  all  too  likely  to  be  mistaken  for 
the  actual  cause  of  the  nervous  disorder. 

This  element  of  heredity  as  a  factor  in  the  causation  of  the 
neurasthenic  state  is  of  great  importance  when  it  comes  to 
the  prognosis.     Regarding  this  point,  Dubois  says: 

Often,  alas,  one  has  to  withdraw  from  the  favorable  prognosis 
that  one  has  made  as  the  result  of  a  temporary  therapeutic  success, 
for  some  years  afterwards  one  finds  the  subject  with  fully  developed 
psychasthenia,  or  affected,  as  the  result  of  an  emotion,  with  mental 
confusion  <.r  melancholia.  In  short,  forgetting  a  little  too  readily 
the  native  predisposition  which  was  postulated  to  explain  how  these 
subjects  succumb  to  commonplace  causes,  a  sort  of  synonymity  is 
created  between  the  terms  true  neurasthenia  and  acquired  neuras- 
thenia, while  the  new  appellation  psychasthenia  has  to  designate  the 
hereditary  or  constitutional  neurasthenia  of  Charot  and  Giles  de  la 
Tourette. 

2.    PHYSICAL    CAUSES 

There  is  little  doubt  in  the  author's  mind  that  physical  habits 
and  practices  have  much  to  do  with  developing  neurasthenia 
in  certain  individuals.  Unhygienic  living,  overeating,  the  sed- 
entary life,  improper  and  inadequate  ventilation  of  living,  work- 
ing, and  sleeping  rooms  —  not  to  mention  the  lash  of  inordinate 
ambition  which  drives  thrifty  men  and  women  to  overwork 
of  both  mind  and  body  —  all  figure  as  causes  in  the  production 
of  neurasthenia. 

It  is  my  observation  that  men  and  women  who  work  with 
their  hands  are  almost  as  highly  subject  to  these  nervous  dis- 
orders as  are  the  more  distinctive  mental  workers  —  professional 
men  and  women.  Overexertion,  physical  as  well  as  mental, 
explains  why  we  find  neurasthenia  almost  as  prevalent  in  the 
country  as  in  the  cities.  This  also  probably  accounts  for  the 
fact  that  men  are  more  prone  to  develop  the  disease  than  women; 
although  women,  when  they  are  attacked,  certainly  break  down 
more  completely  and  abjectly. 

Perhaps  under  the  physical  head  should  also  be  included  those 
cases  of  nervous  prostration  due  to  "  traumatism,"  which  will 


THE  CAUSES  OF  XEURASTHEXIA  145 

be  more  fully  dealt  with  in  a  subsequent  chapter  —  those  sus- 
ceptible individuals  who  pass  through  some  unusual  physical 
or  emotional  experience,  such  as  train  wreck,  and  who,  for  years 
afterwards,  are  confined  to  their  beds  with  traumatic  neuras- 
thenia, u  railway  spine,*'  etc. 

Some  authorities  have  attached  great  importance  to  eye- 
strain and  overworking  of  the  eyes  as  factors  in  the  production  of 
neurasthenia.  There  is  no  doubt  that  this  is  a  fact  in  certain 
individuals;  and  while  I  always  include  a  careful  expert  scrutiny 
of  the  eyes  in  every  routine  examination  of  a  neurasthenic,  I 
do  not  find  disturbances  of  vision  to  play  such  an  important 
role  as  I  was  once  led  to  believe. 

Many  cases  of  neurasthenia  are  either  originated  or  provoked 
by  disease  or  disturbance  in  some  important  internal  organ  or 
organs  of  the  body.  I  am  coming  more  and  more  to  recognize 
that  a  painstaking  and  conscientious  physical  examination  of  the 
average  neurasthenic  patient  seldom  fails  to  reveal  accompany- 
ing physical  disorders  or  derangements  in  one  or  more  of  the 
vital  functions  of  the  body.  It  may  be  argued  by  some  that 
these  physical  disturbances  are  wholly  the  result  of  the  pre- 
existent  neurasthenic  state,  and  to  which  I  would  reply  —  even 
if  this  be  true,  which  I  do  not  allow  in  all  cases,  that  certain 
functional  disturbances  which  at  first  may  be  wholly  due  to 
psychic  disorder  —  to  disordered  neurasthenic  impulses  —  in 
time  come  to  be  so  thoroughly  and  habitually  established  in  the 
system  that  they  must  be  looked  upon  as  actual  physical  func- 
tional disorders  —  and  be  appropriately  treated  and  overcome 
by  proper  physical  remedial  measures.  Mental  therapeutics  alone 
are  inadequate  to  clear  up  the  situation  when  it  has  reached  this 
well-established  and  chronic  state. 

3.    MENTAL    FACTORS 

The  chief  and  characteristic  mental  factor  in  neurasthenia 
is  the  ever  present  tendency  to  make  mountains  out  of  mole 
hills  —  the  inordinate  magnification  of  trifles  —  the  insistent  and 
persistent  habit  of  putting  a  pathological  interpretation  on  a 
host  of  common  everyday  life  experiences  which  are  otherwise 
wholly  normal,  natural,  and  commonplace. 


146  WORRY  AND  NERVOUSNESS 

Uncontrolled  or  unduly  suppressed  emotions  frequently  play 
an  important  part  in  the  production  of  a  disordered  brain 
control  —  a  panicky  mental  state  which  characterizes  typical 
neurasthenia. 

Again,  we  observe  the  neurasthenic  state  mildly  presenting 
itself  in  the  cases  of  predisposed  individuals  who  allow  their 
impulses  and  feelings  habitually  to  work  at  cross  purposes  with 
tluir  environment.  This  sort  of  daily  discontent  constitutes  a 
severe  strain  on  the  integrity  of  the  nervous  mechanism,  and 
sooner  or  later  symptoms  of  demoralization  begin  to  manifest 
themselves.  Inordinate  and  impossible  ambitions  should  be 
placed  in  the  same  neurasthenic-breeding  category. 

Among  the  secondary  mental  causes,  the  most  important  is 
either  a  mental  shock  which  abruptly  and  temporarily  stops  the 
brain  control,  or  some  other  influence  which  in  the  long  run 
wears  out  the  mental  powers;  such  as  sorrow,  prolonged  grief, 
excessive  worry,  or  long  continued  overwork. 

In  proof  of  the  mental  origin  of  many  cases  of  neurasthenia, 
Dubois  cites  the   following  arguments: 

a.  The  fact  that  certain  psychopathies  arise  suddenly  and  under 
the  influence  of  emotional  disturbances. 

b.  Psychopathic  contagion  observed  not  only  in  hysteria  but  also  in 
neurasthenia  and  even  melancholia.  The  fact  that  a  husband  and 
wife  with  different  hereditary  tendencies,  and  educated,  often,  on 
different  lines,  may  conceive  the  same  false  ideas,  and  together  fall 
into  neurasthenia  or  delusions  of  persecution,  indicates  psychic  con- 
tagion by  imitation. 

c.  The  improvement  or  cure  of  psychopathies  by  means  of  purely 
psychic  treatment. 

4.    SOCIOLOGICAL    AND    OCCUPATIONAL    CAUSES 

We  do  not  undertake  to  deny  that  the  strenuous  life  of  modern 
business  (dealt  with  in  chapter  ix),  has  its  influence  in  under- 
mining the  nerves :  neither  do  we  rule  out  the  social  rivalry  with 
its  worry  and  petty  harassments. 

Even  occupational  stress  and  strain  may  play  a  part  —  but 
we  believe  only  a  minor  one  —  in  the  sum  total  of  influences 
which   are   conspiring  together  to   increase  the  prevalence   of 


THE  CAUSES  OF  NEURASTHENIA  147 

nervous  disorders ;  but  over  and  above  all  of  these  minor  causes, 
I  am  forced  to  recognize  the  fact  that  heredity  is  usually  the 
predisposing  cause,  acting  together  with  bad  habits  of  mental 
and  physical  hygiene  as  the  exciting  causes. 

Overwork  may  be  an  occasional  exciting  cause  of  nervous 
breakdown  —  but  I  have  usually  found  the  real  cause  to  be 
over-worry  plus  one  or  more  bad  physical  practices  —  including 
overeating. 

In  the  case  of  the  average  neurasthenic  who  contends  that 
overwork  broke  him  down,  an  investigation  will  usually  disclose 
that  his  bad  physical  practices  coupled  with  bad  thinking  habits 
worked  so  to  undermine  and  deplete  both  his  physical  and 
nervous  energy,  that  it  required  but  the  normal  amount  of  daily 
work  to  prostrate  him.  It  is  not.  as  a  rule,  a  question  of  over- 
work, but  rather  one  of  under-strength  —  all  the  result  of  mental 
and  physical  transgression,  and  that  is  just  the  reason  why  send- 
ing such  neurasthenics  to  the  mountains  or  on  globe-trotting 
excursions  does  little  or  no  good.  They  carry  along  their 
worries  and  bad  physical  habits,  and  consequently  return  in  a 
short  while  no  better  —  and  more  discouraged  than  ever.  In 
order  to  get  well  and  stay  well,  the  average  neurasthenic  must 
do  something  more  than  quit  work  and  run  away  from  noise, 
telephones,  automobiles  and  express  trains. 

Neurasthenia  is  not  confined  to  business  and  professional  men 
whose  work  is  so  complex  and  taxing,  but  is  increasingly  appear- 
ing among  the  middle  and  working  classes,  whose  hygienic 
habits  are  not  the  best,  and  whose  poverty  necessitates  consid- 
erable financial  worry. 

Geographically,  neurasthenia  is  nation-wide  —  world-wide  — 
in  its  distribution ;  but  it  is  erroneously  supposed  to  predominate 
in  the  great  centers  of  population.  It  is  not  true  that  the  cities 
are  the  sole  generators  of  neurasthenia :  the  rural  communities 
and  the  farm  produce  very  nearly  as  many  in  proportion  to 
population.  As  regards  the  United  States,  neurasthenia  is  prob- 
ably more  common  in  the  Middle  West  and  the  Northwest  than 
in  the  central,  southern,  or  eastern  states.  There  is  an  extra 
large  amount  of  this  nervous  disorder  in  the  elevated  Rocky 
Mountain  regions.    Its  prevalence  in  this  region  and  that  of  the 


i48  WORRY  AXD  XERVOVSXESS 

Northwest  is  probably  accounted  for  by  the  extra  strain  upon 
otherwise  predisposed  nerves,  by  the  dry  climate,  stimulating 
altitudes,  strong  winds,  and  excessive  sunshine. 

5.    CITY  AXD  COUXTRY  LIFE 

Regarding  the  city  as  a  factor  in  neurasthenia  as  contrasted 
with  the  country,  Dr.  Kellogg  says : 

We  might  cite  the  fact,  too,  that  neurasthenia  is  more  prevalent  in 
the  cities  than  in  the  rural  districts.  The  comparison  between  the 
agriculturist  and  the  laboring  man  in  the  city  speaks  volumes  for 
the  effects  of  wrong  methods  of  living  upon  the  growth  of  nerve 
disorders.  Neither  class  is  vitally  affected,  so  far  as  the  nature  of 
the  daily  work  is  concerned,  by  the  strenuousness  of  present  day 
life.  "The  plowman  homeward  plods  his  weary  way"  today  much 
as  the  plowman  of  all  times;  he  has  labor-saving  implements  that 
are  new,  but  he  also  attempts  a  larger  program,  so  that  his  way  will 
ever  remain  a  weary  one,  though  healthy  withal.  The  city  worker, 
too,  has  labor-saving  machinery  to  aid  him,  an  assistance  which,  as 
in  the  case  of  the  farmer,  only  allows  him  to  accomplish  more  with- 
out increasing  the  amount  of  fatigue  he  feels. 

But  note  how  differently  the  two  classes  react  to  the  stress  of  toil. 
The  farmer  works  out  of  doors  ten  to  fourteen  hours  a  day.  He  par- 
takes for  the  greater  part  of  clean,  wholesome  food  direct  from  the 
soil.  A  comfortable  living  is  assured  him,  so  that  he  is  untroubled 
by  harrowing  financial  worries.  Living  a  retired  and  quiet  life,  his 
mind  is  untroubled  by  those  industrial  problems  which  stir  the  emo- 
tions and  arouse  the  passions  of  the  workers  of  the  great  cities.  His 
life  in  every  sense  of  the  word  is  the  simple  life,  and  yields  him,  not 
only  muscles  of  steel,  but  also  a  nervous  system  that  is  comparatively 
immune  to  the  symptoms  that  constitute  neurasthenia. 

The  city  worker  leads  a  life  that  is  diametrically  opposed  to  that 
just  described.  As  often  as  not  he  houses  himself  in  a  congested  part 
of  the  city,  where  the  atmosphere  is  fouled  by  the  smoke  of  fac- 
tories, and  in  an  ancient,  ill-ventilated  tenement  that  is  overcrowded 
with  every  sort  and  condition  of  men  and  women,  some  whole,  but 
most  of  them  in  some  stage  of  some  vile  disease.  The  food  he  buys 
is  seldom  undefiled  by  adulterants  that  rob  the  body  of  needed  nour- 
ishment, while  it  also  introduces  into  the  system  poisonous  substances 
that  cripple  muscle  and  nerve  tissue  and  that  pave  the  way  for  the 
worst  form  of  neurasthenia.    As  in  the  case  of  the  farmer,  the  hours 


THE  CAUSES  OF  NEURASTHENIA  149 

of  the  city  workmen  are  likely  to  be  long,  but  instead  of  twelve  hours 
a  day  in  the  out-of-doors,  he  lives  ten  hours  in  a  hot  overpopulated 
room  that  reeks  with  the  poisonous  exhalations  of  the  workmen. 
This  type  of  worker,  too,  seldom  knows  what  it  means  to  be  free 
from  the  bread-and-butter  problem,  his  worries  beginning  when  as 
a  lad  he  first  enters  the  factory.  Here  we  have  conditions  that  are 
ideal  for  the  development  of  symptoms  which  are  a  never  failing  sign 
of  neurasthenia. 

6.    PHYSICAL   DISEASES 

As  an  important  cause  of  neurasthenia  —  far  more  common 
than  is  generally  recognized,  there  should  be  mentioned  visceral 
disorders,  disturbances,  and  dislocations  in  one  or  more  of  the 
vital  organs  of  the  body.  Nose  and  throat  diseases  are  also 
common  causes.  Adenoids,  for  instance,  are  a  more  frequent 
cause  than  eye  troubles  of  nervousness  among  children.  One 
of  the  first  things  which  a  school  medical  inspector  or  school 
nurse  aims  to  do  is  to  seek  out  cases  of  adenoids  and  have  them 
removed.  The  result  is  always  beneficial,  the  child  losing  its 
nervousness  and  becoming  normal  in  almost  every  respect. 

What  some  physicians  call  "  splanchnic  neurasthenia,'"  a  condi- 
tion in  which  the  stomach  and  intestines  are  prolapsed  and 
displaced,  the  displacement  bringing  into  the  abdominal  viscera 
an  abnormally  large  amount  of  blood  and  depriving  the  spinal 
cord  and  brain  of  their  proper  share,  is  responsible  for  a  large 
amount  of  u  nervousness."  Anything  which  interferes  with  the 
proper  functioning  of  the  intestinal  tract  —  the  stomach  and 
bowels  —  is  a  direct  source  of  nervousness,  as  is  also  any  dis- 
turbance of  the  natural  functions  of  the  liver  or  kidneys. 

Serious  mental  disturbances  are  often  observed  following 
typhoid  fever,  in  consequence  of  an  invasion  of  the  brain  by  the 
typhoid  bacteria ;  and  the  same  is  the  case  after  such  germ  dis- 
eases as  influenza,  malaria,  and  yellow  fever ;  but  the  worst  of 
all  infections  for  the  central  nervous  system  is  syphilis.  This 
can  lead  at  once  to  all  sorts  of  new  formations,  inflammations, 
destructions  of  tissue,  and  shrinkings  in  the  brain,  spinal  cord, 
and  nerves,  and  which  in  their  turn,  give  occasion  for  such 
grave  nervous  disturbances  as  pains,  paralyses,  cramps,  con- 
vulsions, and  even  the  dreaded  locomotor  ataxia. 


150  WORRY  AND  NERVOUSNESS 

It  is  a  peculiar  fact  that  in  the  races  who  abstain  from  alcohol 
(the  Mohammedans),  syphilis  almost  never  leads  to  brain 
paralysis,  while,  on  the  other  hand,  it  does  so  all  the  more  fre- 
quently when  alcoholism  is  also  present. 

Certain  nervous  disturbances  are  also  caused  by  general 
metabolic  diseases,  such  as  gout  and  certain  glandular  diseases, 
diabetes,  myxoedema,  etc 

7-    POISONS  AS  A  FACTOR 

We  have  discussed  the  hereditary,  physical,  mental,  social,  oc- 
cupational, and  disease  causes  of  nervousness,  and  now,  last  but 
by  no  means  least,  we  must  consider  the  role  of  chronic  poisoning 
in  the  production  of  neurasthenia.  We  may  classify  the  poisons 
concerned  at  this  time  under  three  heads,  as  follows : 

a.  Poisons  normally  formed  within  the  body.  (Metabolic 
poisons.) 

b.  Poisons  pathologically  formed  within  the  body.  (Disease 
toxins.) 

c.  Poisons  taken  into  the  body  from  the  outside. 

It  has  been  my  experience  that  practically  every  case  of 
acquired  neurasthenia  —  especially  where  the  hereditary  taint 
is  not  marked  (I  do  not  include  psychasthenia) — presents  on 
careful  examination  more  or  less  involvement  with  one  or  more 
of  these  three  groups  of  chronic  systemic  poisoning.  It  often 
proves  a  source  of  great  encouragement  to  the  nervous  sufferer 
to  find  in  these  forms  of  self-poisoning  and  autointoxication 
certain  definite  sources  of  their  nervous  irritation,  and  they  take 
hold  with  new  courage  to  cooperate  with  the  physician  in  an 
earnest  effort  to  remove  all  causes  of  their  trouble  —  physical 
as  well  as  mental.  Let  us  now  consider  these  poison  sources  of 
mischief  to  the  nervous  system  in  the  order  already  noted. 

The  normal,  healthy  human  body  is  constantly  at  work  elab- 
orating certain  poisons  as  a  part  of  the  daily  nutritional  opera- 
tion of  the  organism.  In  the  case  of  normal  individuals  these 
poisons  are  either  burned  up  by  the  liver  or  eliminated  by  the 
kidneys  and  that  is  the  end  of  it;  but  it  is  not  so  with  the  man 
or  woman  with  easily  irritated  nerves:  these  unfortunate  suf- 
ferers  find   themselves   affected  by   oversensitiveness   to   these 


THE  CAUSES  OF  NEURASTHENIA  151 

natural  and  ordinary  internal  situations,  just  as  they  are  over- 
stimulated  and  excited  by  their  normal  outside  surroundings. 

METABOLIC    POISONS 

The  origin  of  these  nutritional,  acid-poisons  within  the  body 
may  be  traced  back  to  the  wastes  which  result  from  muscular 
work  and  to  the  poisonous  wastes  resulting  from  the  putrefaction 
of  food  stuffs  in  the  intestinal  tract,  chiefly  the  large  bowel 
or  colon.  These  decay-poisons  from  the  bowel  when  absorbed 
into  the  circulation,  are  carried  to  all  parts  of  the  body  and 
exert  a  peculiarly  paralyzing  influence  on  both  muscles  and 
nerves.  These  evils  of  autointoxication  are  greatly  aggravated 
when  the  diet  is  heavy  in  protein:  and  protein  is  the  chief 
constituent  of  meat,  cheese,  eggs,  dried  peas  and  beans,  and 
some  of  the  nuts. 

A  very  frequent  cause  of  autointoxication  is  chronic  con- 
stipation. This  condition  is  one  of  the  greatest  enemies  of  nerve 
efficiency,  a  fact  seen  in  the  remarkable  readiness  with  which 
many  nervous  symptoms  disappear  when  constipation  is  removed. 
Otherwise,  the  food  residues  and  wastes  accumulate,  converting 
the  colon  into  a  sort  of  cesspool,  from  which  the  most  noisome 
and  poisonous  substances  filter  through  into  the  circulation  to 
attack  the  entire  nervous  system. 

Muscular  and  mental  work  are  performed  at  the  expense  of  nerves 
and  muscle  tissues.  In  all  exertion  there  are  produced  in  the  body 
poisonous  substances  known  as  "  fatigue  toxins."  Under  normal 
circumstances  these  toxins  are  eliminated  from  the  body  by  way  of 
the  liver,  kidneys,  lungs,  and  perspiration.  When  work,  however, 
reaches  the  point  of  fatigue,  these  poisons  are  increased  beyond  the 
power  of  overworked  eliminative  organs  to  take  care  of,  with  the 
result  that  they  flood  the  body,  attacking  the  nerves  and  forming  a 
powerful  factor  in  the  production  of  neurasthenia.  Note  that  it  is 
not  the  work  of  itself  that  is  responsible  for  the  nervousness,  for 
fatigue  products  themselves  are  a  normal  product  of  body  activity, 
but  that  it  is  the  inability  of  the  eliminative  organs  to  carry  out  their 
normal  function  of  ridding  the  system  of  its  normal  poisons.  It  is 
possible,  it  is  true,  to  carry  exertion  to  the  point  of  extreme  fatigue, 
in  which  case  the  poisons  are  increased  to  a  dangerous  degree  —  very 
many  cases  of  neurasthenia  will  be  found  due  to  this  overfatigue  — 


152  WORRY  AND  NERVOUSNESS 

but  very  often  in  cases  ascribed  to  extreme  fatigue,  the  real  trouble 
lies  in  the  overworked  and  crippled  condition  of  the  organs  of  poison 
elimination. 

EFFECT    OF    FATIGUE    POISONS 

Apply  these  considerations  to  a  typical  case  of  neurasthenia 
and  it  is  readily  explained.  Work  may  have  something  to  do 
with  it,  for  all  work  involves  fatigue,  and  it  is  not  to  be  denied 
that  normal  fatigue  due  to  normal  work  tends  to  lower  the 
threshold  of  the  undesirable  emotions  and  to  inhibit  the  desirable 
ones.  The  effect  of  work  alone  is  normally  slight,  however,  and 
is  quickly  recovered  from;  a  night's,  or  at  most  a  few  days' 
rest  would  insure  recovery  if  the  work  were  the  only  unfavorable 
factor ;  but  along  with  the  work  are  occasions  for  vexation, 
anxiety  and  alarm.  The  neurasthenic  through  heredity,  disease 
or  traumatism  has  a  brain  which  reacts  excessively  to  these  occa- 
sions; to  the  moderate  fatigue  of  useful  labor  is  added  the 
great  fatigue  of  useless  emotion;  the  neurons  whose  efferent 
impulses  disturb  the  body  become  more  sensitive,  lowering  the 
threshold  still  further;  thus  the  daily  number  of  emotional  dis- 
turbances increases.  The  sensory  centers  of  the  cortex  in 
which  the  emotion  ends  become  more  and  more  fatigued,  so  the 
resultant  sensations  become  more  and  more  unpleasant.  This 
change  in  sensations,  especially  in  those  of  the  head,  causes  a 
feeling  of  changed  personality  which  is  strongly  suggestive  of 
mental  disease,  and  thus  the  earlier  fears  of  heart-disease, 
apoplexy,  or  what  not,  become  relatively  unimportant  before  the 
terrible  fear  of  insanity. 

And  so  we  come  to  recognize  that  any  physical  cause  what- 
ever, which  overexcites,  exhausts,  or  intoxicates  the  nervous 
system  creates  a  condition  of  mental  stress  and  disorder.  The 
highly  sensitized  body  of  civilized  man  is  susceptible  to  many 
physical  disturbances  that  are  as  yet  little  understood.  Many 
toxins  are  produced  in  the  body  which  directly  affect  the 
nervous  system.  The  products  of  muscle  fatigue,  of  certain 
foods,  of  some  purely  physiological  processes  in  the  body  are 
known  to  affect  the  mental  life,  and  there  are  still  other  changes, 
as  vet  obscure,  which  may  create  mental  or  nervous  conditions, 


THE  CAUSES  OF  NEURASTHENIA  153 

apparently  independently  of  wrong  or  unhygienic  mental  activity 
of  any  kind.  In  general,  whatever  causes  production,  in  excess, 
of  poisons  in  the  body,  or  prevents  proper  elimination  of  them, 
may  enter  into  the  nervous  life. 

THE   TOXINS  OF   INFECTION 

It  is  a  common  bit  of  neurasthenic  history  that  the  disorder 
made  its  first  appearance  following  an  attack  of  some  infectious 
disease  —  typhoid  fever,  rheumatism,  tonsilitis,  influenza,  etc. 
These  microbic  poisons  circulate  in  the  blood  stream  and  pro- 
voke mischief  in  the  same  identical  manner  that  we  have  just 
noted  in  our  study  of  metabolic  poisons  and  those  produced  by 
disordered  digestion  and  mal-assimilation. 

POISONS  TAKEN   INTO  THE   BODY 

The  physician  who  is  thrown  in  contact  with  a  large  number 
of  nervous  cases  cannot  help  but  recognize  that  certain  drugs 
exert  a  peculiarly  bad  influence  upon  the  average  neurasthenic. 
Whatever  may  be  said  against  the  habitual  use  of  tobacco  by 
the  man  of  strong  nerves,  holds  doubly  —  yes  even  trebly  —  true 
of  the  neurasthenic. 

Particularly  serious  is  the  effect  of  tobacco  upon  the  neuras- 
thenic nervous  system,  an  effect  which  manifests  itself  in  a 
variety  of  ways.  For  the  time  being,  tobacco  sometimes  appears 
to  give  tone  and  steadiness  to  the  nerves,  but  this  effect  is 
deceptive  and  the  ultimate  effect  is  to  increase  the  very  difficulty 
which  it  had  the  appearance  of  benefiting.  The  best  proof, 
perhaps,  of  the  injurious  nature  of  the  drug  is  the  fact  that  in 
scores  of  cases  which  we  have  observed,  the  nervous  symptoms 
have  largely  or  entirely  disappeared  when  the  patient  cut  down 
or  wholly  discontinued  the  use  of  tobacco. 

It  must  be  borne  in  mind  that  one  ordinarily  feels  languid, 
depressed,  and  good  for  nothing,  when  the  blood-pressure  is  too 
low :  whereas  one  usually  feels  exhilarated  and  tiptop  when  the 
pressure  is  high.  Therefore,  there  is  a  constant  tendency  for 
neurasthenically  inclined  persons  to  make  use  of  those  drugs 
which  increase  the  blood-pressure,  or  in  cases  of  suffering  from 


154  WORRY  AND  NERVOUSNESS 

low  pressure,  to  resort  to  the  use  of  high-pressure  procedures 
to  counteract  the  unpleasant  low-pressure  effects. 

TOBACCO 

Tobacco  stands  foremost  among  the  common  causes  of  in- 
creased blood-pressure.  It  is  well  known  that  when  a  young 
man  takes  his  first  smoke,  he  is  pale  in  the  face;  the  small 
blood-vessels  of  the  skin  are  strongly  contracted;  the  blood  is 
forced  upon  the  internal  organs.  The  blood-pressure  if  taken 
at  such  a  time,  is  found  to  be  enormously  raised;  and  so 
throughout  life  the  effect  of  tobacco-using,  due  to  the  specific 
action  of  the  nicotine  and  other  poisons,  is  that  of  directly 
raising  the  blood-pressure.  (A  single  cigar  raises  blood-pressure 
for  over  one  hour.)  The  use  of  tobacco,  then,  may  be  regarded 
as  one  of  the  prominent  causes  of  increased  blood-pressure  in 
the  present  generation,  and  of  many  of  the  serious  dangers  and 
consequences  following,  namely:  deranged  nervous  system, 
hardened  arteries,  kidney  trouble,  heart  failure,  and  apoplexy. 
The  long  continued  and  excessive  use  of  tobacco  sometimes  re- 
sults in  bringing  about  a  reaction  —  an  abnormal  lowering  of 
the  blood-pressure. 

The  enormous  increase  in  the  use  of  tobacco  is  astounding. 
Last  year  the  American  youth  consumed  enough  cigarettes,  if 
placed  end  to  end,  to  go  around  the  world  six  times,  and  then 
from  Xew  York  to  San  Francisco  and  back  again.  In  other 
words,  they  smoked  in  the  neighborhood  of  six  million  manu- 
factured cigarettes  in  one  year,  (this  does  not  include  cigarettes 
made  by  the  smokers  themselves),  to  say  nothing  about  the 
enormous  quantities  of  smoking  tobacco  and  chewing  tobacco 
used  by  the  same  people.  The  cigars  used  last  year  if  laid  end 
to  end,  would  reach  almost  to  the  moon  —  a  distance  of  two 
hundred  and  forty  thousand  miles.  There  were  used  last  year 
in  the  United  States,  twenty  million  pounds  of  snuff,  although 
this  habit  is  supposed  to  be  obsolete. 

American  men  and  boys,  therefore,  last  year  smoked  con- 
siderably over  fifteen  thousand  million  cigars  and  cigarettes. 
These,  if  laid  end  to  end,  would  reach  almost  from  our  earth 
to  the  moon  and  back  again. 


THE  CAUSES  OF  NEURASTHENIA  155 

ALCOHOL 

Of  all  the  habits  which  have  blighted  the  world  the  use  of 
alcohol  has  had  perhaps  the  most  sinister  results.  Great  empires 
have  fallen  as  the  result  of  degeneracy  due  in  a  great  part  to  this 
drug;  primitive  peoples,  such  as  the  North  American  Indians, 
are  wasting  away  as  the  result  of  the  drink  habit  acquired  from 
the  white  race.  The  evils  attendant  upon  the  use  of  opium, 
cocaine,  morphine,  absinthe,  and  other  narcotics  are  not  a 
particle  less  appalling  than  those  due  to  the  drugs  we  have 
already  named.  Their  use,  however,  is  less  wide-spread;  the 
campaign  of  education  which  has  been  brought  to  bear  upon 
them  has  rendered  them  less  popular  than  tobacco  and  alcohol, 
for  owing  to  some  inexplicable  foible  in  the  popular  mind  the 
"  dope  fiend "  has  come  to  be  regarded  with  more  or  less 
repugnance,  whereas  the  tobacco  or  alcohol  fiend  is  not  only 
tolerated,  but  often  exalted  to  a  position  bordering  upon  heroism. 
Alcohol  is  one  of  the  ancestors  of  neurasthenia. 

NARCOTIC    BEVERAGES 

Tea  and  coffee  come  next  in  the  list  of  popularly  used  poisons 
which  contribute  to  wide-spread  nervousness.  It  is  a  well  known 
fact  that  whatever  excites  vital  action  above  the  normal  stand- 
ard, without  supplying  an  extra  amount  of  force  to  support  this 
extra  expenditure,  invariably  produces  a  necessary  and  corre- 
sponding depression  of  vital  action  below  the  normal  standard, 
or  what  is  known  as  a  "  reaction."  That  this  is  one  of  the  sec- 
ondary results  of  the  excessive  use  of  strong  tea  is  well  known. 

The  continued  alternation  of  excitement  and  reaction  must 
certainly  result  in  injury  to  the  nervous  system,  increasing  the 
liability  to  nervous  disorders  of  a  functional  nature,  such  as 
neuralgia,  hysteria,  etc. 

Doctor  Bock,  of  Leipsic,  once  remarked: 

The  nervousness  and  peevishness  of  our  times  are  chiefly  at- 
tributable to  tea  and  coffee.  The  digestive  organs  of  confirmed 
coffee  drinkers  are  in  a  state  of  chronic  derangement  which  reacts 
on  the  brain,  producing  fretful  and  lachrymose  moods.  Fine  ladies 
addicted  to  the  use  of  strong  coffee  have  a  characteristic  temper 


i56  WORRY  AND  NERVOUSNESS 

which    I    might    describe    as    a    mania    for    acting    the    persecuted 
saint. 

Dr.  B.  W.  Richardson,  the  noted  English  physician,  says: 

Among  the  women  who  take  tea  at  every  meal,  this  extremely 
nervous,  semi-hysterical  condition  from  the  action  of  the  tea  is  all 
but  universal.  In  London  and  other  fashionable  centers  in  which  the 
custom  of  tea  drinking  in  the  afternoon  lias  been  revived,  these  same 
symptoms  have  been  developed  in  the  richer  classes  of  society,  who. 
unfortunately,  too  often  seek  to  counteract  the  mischief  by  resorting 
to  alcoholic  stimulants.    Thus  one  evil  breeds  another  that  is  worse. 

There  is  used  in  the  United  States  several  hundred  million 
pounds  of  tea  and  coffee  a  year  —  that  is —  over  ten  pounds  of 
tea  and  coffee  a  year  for  every  man.  woman  and  child  in  the 
country.  Tea  and  coffee  are  freely  used  even  by  young  children 
with  tender  nervous  systems.  We  have  the  "  tea-drinker's  dis- 
order," which  is  a  disease  recognized  by  the  medical  profession; 
and  tea-topers  are  found  among  both  men  and  women.  This  tea 
and  coffee  drinking  is  none  the  k-^>  a  case  of  drug-addiction, 
even  though  it  be  taken  at  meal  time,  and  notwithstanding  that 
its  use  has  become  well-nigh  universal. 

OTHER   NERVE   IRRITANTS 

A  class  of  substances  which  are  not  generally  classed  as 
poisons,  but  which  are  almost  as  irritating  in  their  effects  on 
the  nerves  are  the  condiments.  Pepper,  mustard,  vinegar, 
horse-radish,  cayenne,  spices,  capsicum,  and  their  congeners 
irritate  the  delicate  linings  of  the  stomach  and  intestines,  inhibit 
a  natural  flow  of  the  digestive  juices,  and  so  derange  the 
processes  of  digestion  as  to  render  the  user  an  easy  prey  to  many 
a  nervous  outbreak.  Neurasthenics  should  beware  of  foods 
that  are  hot  when  they  are  cold. 

The  American  people,  in  common  with  their  English  cousins, 
consume  enormous  quantities  of  the  flesh  of  animals  for  food. 
All  forms  of  flesh  food  contain  certain  irritating  substances, 
such  as  uric  acid  which  was  circulating  through  the  flesh  of  the 
animal  at  the  instant  of  death,  and  which  is  swallowed  along 
with  the  meat,  and  has  power  to  raise  the  blood-pressure  con- 
siderably by  its  irritating  effect  on  the  tender  linings  of  the 


THE  CAUSES  OF  NEURASTHENIA  157 

blood-vessels  and  its  influence  upon  the  nervous  system.  Ex- 
cessive meat  eating  is  another  cause  at  the  bottom  of  our  ten- 
dency to  "  neurasthenia." 

With  this  group  of  poisons  taken  into  the  system  from  without 
may  also  be  mentioned  the  poisons  of  impure  air.  Typical 
results  of  air  toxication  are  seen  in  the  case  of  ill-ventilated 
school  rooms.  The  characteristic  effects  are  languor,  dullness, 
and,  in  time,  irritability,  due  to  a  poisoned  condition  of  the 
nervous  system.  The  effects  are  just  as  pronounced  in  homes 
that  lack  proper  facilities  for  ventilation. 

Patent  medicines,  headache  powders,  and  pain  relievers  must  also 
be  classed  as  a  very  important  cause  of  nervousness.  In  most 
instances  they  contain  a  large  proportion  of  alcohol,  which  acts  on 
the  system  in  the  same  manner  as  indicated  in  the  foregoing  para- 
graphs on  alcohol.  Opiates  and  narcotics  are  also  very  frequently 
present,  especially  cocaine  and  opium,  introduced  for  the  purpose  of 
rendering  the  nerves  insensible  to  pain,  without  at  the  same  time 
removing  the  causes  of  the  pain. 

SUMMARY    OF    THE    CHAPTER 

1.  While  heredity  predisposes  to  nervousness,  nevertheless, 
neurasthenia  is  an  acquisition,  not  an  inheritance.  True,  neu- 
rasthenia develops  on  the  hereditary  base;  the  acquired  form 
springs  up  as  a  result  of  stress  and  strain. 

2.  The  physical  causes  of  neurasthenia  embrace  unhygienic 
living,  overeating,  the  sedentary  life,  overwork,  accidents,  eye- 
strain, and  physical  diseases. 

3.  The  mental  factors  in  nervous  exhaustion  are :  the  magnifi- 
cation of  trifles,  misdirected  emotion,  uncontrolled  impulses, 
misinterpreted  feelings,  daily  discontent,  mental  shock,  worry, 
overstudy,  and  anxiety. 

4.  Neurasthenia  attacks  the  laboring  classes  as  well  as  pro- 
fessional people.  Geographically,  the  largest  proportion  of  cases 
are  found  in  the  Northwest  and  in  the  higher  altitudes  of  the 
West. 

5.  While  neurasthenia  is  found  in  the  country  as  well  as  in  the 
city,  it  predominates  in  the  city  as  a  result  of  bad  living,  sleeping, 
and  working  habits  —  not  to  mention  intemperance. 

6.  Physical  diseases,  such  as  visceral  misplacements  and  con- 
gestion,'portal  (liver)  congestion,  typhoid,  influenza,  malaria, 
syphilis,  glandular  disorders,  and  even  adenoids,  are  all  exciting 
causes  of  nervousness. 


158  WORRY  AND  NERVOUSNESS 

7.  Poisons  are  a  great  factor  in  the  causation  of  neurasthenia. 
They  may  be  classified  as  (1)  Metabolic  poisons,  (2)  Disease 
toxins,  and  (3)  Poisons  taken  in  from  the  outside. 

8.  Metabolic  poisons  are  those  substances  normally  formed 
within  the  body,  but  poorly  eliminated  and  badly  borne  by  the 
neurasthenic. 

9.  Muscular  fatigue  poisons,  while  unnoticed  by  the  healthy 
organism,  are  extraordinarily  irritating  and  depressing  to  the 
neurasthene. 

10.  Any  and  all  influences  which  overexcite,  exhaust,  irritate, 
or  intoxicate  the  oversensitive,  nervous  system  of  the  neuras- 
thene, contribute  directly  to  an  aggravation  of  all  his  troubles. 

11.  The  toxins  of  infection  —  typhoid,  influenza,  rheumatism, 
tonsilitis,  like  the  metabolic  poisons,  all  serve  to  irritate  and 
excite  the  neurasthenic's  nerve?. 

12.  Chief  among  those  poisons  taken  into  the  body  from  the 
outside  may  be  mentioned  tobacco,  alcohol,  narcotic  beverages, 
patent  medicines,  etc. 

13.  While  tobacco  sometimes  appears  to  steady  the  nerves,  this 
effect  is  largely  deceptive,  and  is  due  to  its  influence  in  raising 
the  blood-pressure.  Of  all  persons,  neurasthenics  should  not 
smoke. 

14.  Alcohol  is  one  of  the  ancestors  of  neurasthenia.  By  under- 
mining the  nervous  system  of  the  individual,  it  has  contributed 
largely  to  the  downfall  of  the  great  nations  of  history. 

15.  Narcotic  beverages  —  tea  and  coffee  —  whatever  their 
effect  upon  the  healthy  nervous  system,  must  be  regarded  as 
injurious  drugs  by  the  neurasthenic. 

16.  Medical  authorities  look  upon  tea  as  especially  harmful  to 
irritable  and  overwrought  nerves. 

17.  The  ordinary  condiments  —  pepper,  mustard,  vinegar, 
spices,  etc.  —  are  probably  irritating  to  the  nerves  as  well  as  to 
the  digestive  mucous  membranes.  Neurasthenics  should  beware 
of  foods  that  are  hot  when  they  are  cold. 

18.  A  high  protein  diet  —  excessive  meat  eating  —  may  be  a 
factor  in  increasing  nervousness,  due  to  the  irritating  and  acid 
character  of  the  various  animal  extractives. 

19.  Among  other  poisonous  factors  may  be  mentioned  bad  air, 
patent  medicines,  headache  powders,  pain  relievers,  etc. 


CHAPTER  XIII 
THE  EAR-MARKS  OF  NEURASTHENIA 

THIS  chapter  is  devoted  to  the  symptoms  of  the  neuras- 
thenic states.  The  author  has  a  two-fold  purpose  in  so 
fully  presenting  these  varied  and  numerous  earmarks  of  the 
different  forms  of  irritable  nervous  weakness.  First,  we  are 
desirous  of  making  it  perfectly  plain  to  the  neurasthene  that 
medical  men  are  thoroughly  conversant  with  all  phases  of 
neurasthenia;  and,  second,  if  possible,  finally  to  convince  these 
nervous  sufferers  that  their  afflictions  are  not  unique,  to  show 
them  that  the  doctor  has  met  many  a  case  just  like  theirs. 

CARDINAL    SYMPTOMS 

While  many  of  the  symptoms  hereafter  noted  may  belong  to 
the  early  or  latent  period  of  neurasthenia,  and  while  others  be- 
long to  the  later  or  chronic  stage  of  the  disorder,  nevertheless 
they  will  all  be  grouped  together  in  this  place,  regardless  of  the 
particular  stage  of  the  disorder  in  which  they  customarily 
appear. 

It  should  also  be  remembered  that  no  single  patient  was  ever 
tormented  and  plagued  with  all  the  symptoms  here  mentioned. 
This  chapter  in  a  general  way  includes  all  of  the  symptoms  of 
all  of  our  patients  —  that  is,  the  leading  and  more  constant 
complaints  which  the  average  neurasthene  is  accustomed  to 
make. 

Before  beginning  the  recital  of  concrete  and  definite  symp- 
toms, the  reader's  attention  is  called  to  the  fact  that  all  forms  of 
nervous  weakness  are  characterized  by  four  cardinal  and  char- 
acteristic symptoms,  viz. : 

1.  Exaggerated    suggestibility. 

2.  Over-sensitiveness. 

3.  Abnormal  impressibility. 

4.  Increased  emotionalism. 

159 


i6o  WORRY  AND  NERVOUSNESS 

These  four  states  have  been  quite  fully  treated  in  former 
chapters  and  it  will  suffice  for  the  present,  merely  to  call  atten- 
tion to  the  fact  that  they  all  owe  their  origin  and  existence  to 
that  common-place  mental  state  of  chronic  worry  —  fear.  One 
writer  has  said  that  "  the  nervously-weak  individual  enacts 
his  role  in  the  drama  of  life  while  in  a  state  of  perpetual 
stage-fright." 

PSYCHIC    SYMPTOMS 

Of  all  the  neurasthenic  symptoms,  the  most  common,  the 
most  prominent  —  and,  to  the  patient,  the  most  alarming  —  are 
those  unique  psychic  disturbances  which  are  characterized  by  a 
flock  of  abnormal  thoughts  and  a  flood  of  unhealthy  feelings. 

The  majority  of  neurasthenics  have  long  been  given  to  worry, 
and  while  they  suffer  more  or  less  from  phobias  in  general  and 
the  "  blues  "  in  particular,  they  are  usually  victims  of  one  or 
more  definite  dreads.  They  are  unduly  anxious  about  the  future 
and  are  given  to  premonitions  —  they  are  extraordinarily  appre- 
hensious  of  some  impending  doom,  especially  is  this  true  during 
their  periodic  seasons  of  depression  —  those  characteristic  fits 
of  neurasthenic  despair. 

While  these  nervous  sufferers  are  more  or  less  concerned  over 
these  periods  of  sadness  and  depression,  the  thing  which  more 
greatly  alarms  them  is  their  manifest  tendency  to  ''brain  wan- 
dering"—  loss  of  conscious  control  over  the  mind  —  and  in 
the  more  severe  or  advanced  cases,  an  actual  loss  or  weakening 
of  the  memory:  and  this  is  a  symptom  which  the  average  neuras- 
thenic interprets  as  a  sure  fore-runner  of  insanity;  and  thus 
all  their  former  fears  and  anxieties  are  increased  many  fold. 

MENTAL  CONFUSION 

In  other  patients  the  leading  symptom  is  a  slowly  developing 
dreamy  state  of  mind,  accompanied  by  lack  of  interest  in  life  — 
a  pitiful  sort  of  generalized  apathy.  Vagueness  of  both  ideas 
and  feelings,  which  progresses  from  month  to  month  until  the 
patient  is  overwhelmed  by  utter  mental  confusion,  and  then 
follows  that  pathetic  spectacle  of  almost  entire  loss  of  self 
confidence  —  that   abject   feeling  of  inferiority.     The  neuras- 


THE  EAR-MARKS  OF  NEURASTHENIA  161 

thenic's  motto  seems  to  be:  never  do  today  anything  you  can 
put  off  until  tomorrow. 

And  all  of  this  cannot  help  but  lead  the  patient  to  dread  the 
future.  His  fears  are  multiplied,  his  obsessions  increased,  his 
premonitions  intensified,  while  his  apprehensions  are  enormously 
magnified.  The  sufferer  reflects  on  everything  he  does,  and 
reasons  on  all  his  thoughts  without  reaching  a  definite  and 
practical  decision.  He  lives  very  little  in  the  present  and  his 
thoughts  always  turn  to  the  past  or  the  future.  We  must  not 
overlook  the  fact  that  during  the  time  all  these  manifestations 
of  psychic  disturbances  are  presenting  themselves,  the  patient's 
nervous  irritability  is  enormously  increased  and  that  the  various 
physical  and  sensory  symptoms  which  accompany  these  psychic 
symptoms  unfailingly  lead  to  a  serious  degree  of  morbid  intro- 
spection. And  all  this  results  in  the  development  of  extraordi- 
nary and  unhealthy  egotism,  culminating  in  temperamental 
irritability,  pitiful  selfishness,  and  those  characteristic  fits  of 
neurasthenic  anger. 

SELFISHNESS    AND   EGOTISM 

Another  and  peculiar  psychic  twist  in  the  neurasthenic's 
experience  is  the  peculiar  and  sometimes  violent  manner  in 
which  he  reacts  to  his  own  personality  as  well  as  to  his  family 
and  friends.  In  the  most  freaky  and  lawless  manner,  the 
patient  is  either  repelled  or  drawn  by  various  mental  and 
physical  characteristics. 

Reasoning  is  more  or  less  superficial  while  judgment  is 
hasty  and  final  decisions  are  therefore  ill-formed  and  highly 
unsatisfactory.  All  capacity  for  mental  work  is  greatly 
abridged,  and  there  is  soon  developed  a  sort  of  mental  asthenia. 
On  the  other  hand,  and  in  contrast  with  this  state,  there  not 
infrequently  appears,  from  time  to  time,  a  sort  of  "  psychic 
explosion  "  which  sets  the  mental  machinery  running  at  a  rapid 
pace  for  a  short  season.  These  are  the  spells  of  so  called 
"  spontaneous  mentation,"  which,  unfortunately,  ofttimes  assail 
the  nervous  sufferers  in  the  dead  of  night. 

There  is  just  one  other  peculiar  mental  trait  or  trick  which 
should   be   noted,   viz. :   the   characteristic  loss   of   the   natural 


162  WORRY  AND  NERVOUSNESS 

affections  —  accompanied  by  that  ever-present  peevishness  — 
which  makes  it  so  hard  for  the  neurasthenic's  family  either  to 
please  him  or  live  with  him. 

The  victim,  too,  becomes  extremely  sensitive  with  regard  to  his 
own  personal  dignity.  lie  meets  a  friend  on  the  street  who,  absorbed 
in  some  problem,  passes  him  by  without  recognition.  The  act  is  at 
once  construed  into  a  personal  slight.  The  neurasthenic  must 
occupy  the  limelight  in  the  attention  of  his  friends,  or  he  feels  him- 
self neglected.  Even  his  conscience  becomes  abnormally  acute,  tak- 
ing on  the  same  extraordinary  sensitiveness.  His  every  decision,  his 
every  thought  and  act  is  scrutinized  lest  it  have  a  wrong  motive;  the 
result  is,  of  course,  that  he  finds  what  he  looks  for  and  becomes 
depressed  and  gloomy,  making  himself  a  burden,  not  only  to  himself, 
but  to  all  with  whom  he  comes  in  contact.  Another  frequent  symp- 
tom of  neurasthenia  is  feebleness  of  will  power,  an  inability  to  arrive 
at  a  decision  when  confronted  with  difficult  problems  of  any  kind. 

CEREBRAL    SYMPTOMS 

Chief  among  the  neurasthenic's  sufferings  are  those  symptoms 
pertaining  to  the  head.  When  these  so-called  cerebral  symptoms 
predominate  —  greatly  overshading  the  other  nervous  mani- 
festations —  it  is  customary  to  diagnose  the  case  as  one  of  "  cere- 
bral neurasthenia." 

One  of  the  most  common  cranial  symptoms,  aside  from  head- 
ache, is  the  feeling  of  a  band  drawn  tightly  around  the  forehead. 
Many  patients  complain  bitterly  of  this  constricting  or  drawing 
sensation.  Other  patients  suffer  greatly  from  a  burning  sensa- 
tion at  some  point  on  the  scalp,  usually  at  the  crown  of  the 
head.  (Often  the  area  involved  actually  feels  hot  to  the  touch.) 
Other  sensations  felt  about  the  head  are  those  of  prickling  and 
crawling,  also  numbness  and  tenderness. 

Some  patients  complain  of  a  sense  of  "  fullness  in  the  head  " 
which  is  very  distressing;  the  head  "  feels  as  if  it  would  burst 
wide  open  any  moment."  Other  sufferers  complain  of  an 
aggravating  sensation  of  "  emptiness  "  in  the  head.  These  same 
feelings  are  also  described  by  the  terms  of  tightness,  heaviness, 
and  the  sensation  of  something  loose,  shaking  about  in  the 
cranium. 


THE  EAR-MARKS  OF  XEURASTHEXIA  163 

Dizziness  —  sometimes  associated  with  the  fear  of  fainting  — 
is  a  common  neurasthenic  symptom.  Some  patients  describe 
their  oppressive  head  feelings  as  a  "  lead  cap  headache." 
Others  have  throbbing,  buzzing  sensations  in  the  head  and 
complain  of  a  sensation  of  wind  blowing  or  water  running 
under  the  scalp. 

FEARS   OF   INSANITY 

It  is  an  established  fact  that  any  and  all  of  these  head  symp- 
toms or  cerebral  manifestations  are  greatly  increased  by  mental 
application;  and  since  self-examination  is  the  principal  occupa- 
tion of  neurasthenics,  a  vicious  circle  is  readily  established, 
whereby  worry  and  anxiety  are  able  enormously  to  increase  these 
symptoms  and  sufferings,  and  thereby  in  turn,  the  worry  and 
anxiety  are  still   further  increased. 

The  patient  is  soon  possessed  with  the  conviction  that  he  is 
rapidly  losing  his  mind  and  begins  his  plans  and  preparations  for 
a  journey  to  the  insane  asylum.  To  the  confirmed  neurasthenic, 
all  these  mental  symptoms  spell  insanity,  just  as  he  looks  upon 
numbness  in  his  hands  or  legs  as  certain  forerunners  of 
paralysis. 

NEURASTHENIC   HEADACHES 

The  headaches  of  neurasthenia  are  usually  located  in  the 
front  or  on  top  of  the  head,  occasionally  in  the  back  part  of  the 
head  or  as  commonly  referred  to  —  the  base  of  the  brain.  The 
patient  usually  describes  his  headache  as  a  sort  of  pressure  or 
pushing  downward  upon  the  head.  Pains  in  the  back  part  of 
the  head  are  usually  described  as  a  dull  ache.  In  fact,  neuras- 
thenic headaches  may  range  from  a  mild  diffuse  pain  up  to 
the  most  severe  pain  imaginable.  In  this  connection  we  are 
dealing  with  only  neurasthenic  headaches;  the  head  pains  of 
hysteria  and  nervous  sick  headache  or  migraine  will  be  treated 
in  other  chapters. 

At  the  time  of  this  writing  there  comes  into  the  office  a  young 
business  man,  manifestly  a  neurasthenic;  among  other  symptoms 
he  complains  of  regular  headaches.  He  also  complains  of  pain 
in  the  back  between  the  shoulder  blades,  especially  in  the  evening 


164  WORRY  AND  NERVOUSNESS 

after  the  day's  work.  The  patient  is  visibly  nervous.  He  has 
various  abnormal  sensations  or  mild  pains  in  various  parts  of 
the  body  from  time  to  time,  and  describes  his  headache  as 
follows : 

"  Well,  I'll  tell  you,  doctor,  my  headache  is  something  like  a 
sensation  of  mildly  squeezing  the  brain.  Sometimes  it  feels 
like  a  pressing  down  sensation  on  top  of  my  head.  At  other 
times  it  feels  as  if  there  were  a  tight  band  around  my  head. 
My  headache  is  usually  very  much  worse  in  the  morning,  be- 
coming a  great  deal  better  or  entirely  disappearing  as  the  day 
wears  on,  while  the  pain  in  my  back,  between  the  shoulders, 
usually  gets  worse  towards  evening.  Sometimes  my  headache 
is  really  not  a  pain,  but  only  a  sensation  of  fullness  or  a  sense 
of  uneasiness  in  the  head." 

While  the  real  cure  of  this  headache  is  to  be  found  in  the 
successful  treatment  of  the  neurasthenia  and  the  improvement 
of  the  general  physical  state ;  nevertheless,  these  headaches  may 
be  greatly  relieved  or  entirely  removed  by  means  of  alternate 
hot  and  cold  compresses  over  the  top  of  the  head  and  the  back  of 
the  neck,  in  connections  with  a  very  hot  foot  bath.  The  hot 
compresses  should  be  wrung  out  of  boiling  water  and  the  cold 
cloths  out  of  ice  water. 

Cases  which  are  not  relieved  by  the  alternate  hot  and  cold 
compresses  to  the  head,  are  usually  relieved  or  greatly  benefited 
by  alternate  hot  and  cold  sponging  of  the  entire  spinal  column. 
The  skin  over  the  spine  is  briskly  rubbed  for  a  few  seconds 
with  a  cloth  wrung  out  of  boiling  water  and  this  is  followed 
by  brisk  rubbing  with  cloths  wrung  out  of  ice  water.  The 
further  treatment  of  neurasthenic  headaches  and  other  symptoms 
will  be  reserved  for  later  chapters. 

SPINAL  MANIFESTATIONS 

Many  of  the  neurasthenic's  complaints  are  found  to  be  con- 
nected with  the  spine,  the  spinal  nerve  centers  and  nerve 
branches.  This  fact  explains  why  certain  cases  of  nervous 
exhaustion  are  diagnosed  as  "  spinal  neurasthenia,"  and  also 
why  osteopathy  has  been  so  popular  —  and  in  many  cases  help- 
ful —  to  these  patients  afflicted  with  "  neurasthenic  spines." 


THE  EAR-MARKS  OF  NEURASTHENIA  165 

These  spinal  neurasthenics  are  all  more  or  less  afflicted  with 
backache  in  common  with  headache,  the  most  frequent  sites 
being  the  small  of  the  back  and  high  up  just  between  the 
shoulder  blades,  and  are  usually  described  as  associated  with  a 
trying  "  drawing  "  sensation  at  the  sides  or  back  of  the  neck. 

Marked  tenderness  on  pressure  is  found  at  various  points 
along  the  spinal  column,  the  favorite  locations  being  at  the 
very  top  near  the  base  of  the  skull,  at  the  waist  line,  and  at 
the  top  of  the  sacrum. 

SENSORY  DISTURBANCES 

The  chief  symptom  of  neurasthenia  is  that  general  feeling 
of  "  tiredness  "  —  constant  fatigue.  In  chronic  neurasthenics 
the  recumbent  posture  tends  to  become  habitual.  These  patients 
are  tortured  off  and  on  by  all  manner  of  vague  and  wandering 
sensations  of  heat,  cold,  prickling,  tightness,  numbness,  stiffness, 
weakness,  soreness,  pain,  pressure,  etc.,  etc.  These  symptoms 
may  be  referred  to  this  or  that  part  of  the  body,  and  in  addi- 
tion there  are  a  host  of  abnormal  feelings  connected  with  the 
internal  organs  of  the  chest,  abdomen,  and  pelvis. 

Some  special  nerve  trunk  may  appear  to  be  tender  to  pressure 
throughout  its  entire  length.  Such  tender  areas  are  likely 
to  be  found  in  the  spaces  between  the  ribs,  under  the  breast, 
at  the  pit  of  the  stomach,  and  in  the  groins.  This  nervous  irri- 
tability becomes  so  exaggerated  at  times  as  to  result  in  the  pro- 
duction of  darting  pains  of  a  neuralgic  nature  which  appear  not 
only  in  these  situations  but  at  various  other  points  on  the 
trunk  as  well  as  the  extremities.  The  patient  becomes  more 
and  more  alarmed,  feels  unfit  for  any  serious  work,  and  begins 
to  behave  like  a  rudderless  ship  in  a  storm.  The  slightest 
exertion  sometimes  results  in  turning  loose  a  veritable  storm  of 
unpleasant  feelings  and  painful  sensations. 

SPECIAL  SENSE   DISORDERS 

Neurasthenics  never  fail  to  complain  that  reading  (especially 
by  artificial  light)  gives  them  a  headache  or  otherwise  distresses 
them.  Sometimes  the  letters  blur,  at  other  times  they  run 
together.      Some    patients    find    reading    difficult   because    they 


1 66  ll'ORRY  AXD  NERVOUSNESS 

simply  cannot  concentrate  the  mind  sufficiently.  The  muscles 
of  accommodation  seem  to  be  overquickly  fatigued.  The  eyes 
are  often  so  sensitive  to  light,  that  the  patient  is  temporarily 
compelled  to  remain  in  a  darkened  room  or  to  wear  colored 
glasses.  Misty  veils  may  appear  to  hang  before  the  eyes  greatly 
to  the  alarm  of  some  patients. 

It  is  common  for  patients  to  complain  of  u  specks  "  before 
the  eyes  when  tired,  or  after  reading;  in  others  the  vision  is 
indistinct  and  confused.  Another  source  of  worry  to  these 
patients  is  the  so-called  negative  images.  After  gazing  for 
a  short  time  at  some  object  presenting  marked  contrasts  of  light 
and  shade,  and  then  when  the  eyes  are  turned  away  for  a 
moment,  this  object  appears  to  the  vision  with  its  light  and  dark 
spots  reversed.  This  peculiarity  of  vision  in  the  neurasthenic, 
together  with  other  and  easily  explained  illusions,  cause  these 
sufferers  a  great  deal  of  unnecessary  worry  and  excitement. 

HEARING   AXD   SMELLING 

Chief  among  the  neurasthenic  disturbances  of  hearing  is 
tinitus  aurum  —  that  constant  ringing  in  the  ears.  They  also 
suffer,  especially  when  lying  down,  with  a  regular  throbbing 
or  pounding  in  the  cars  which  is  synchronous  with  the  heart's 
pulsations.  These  patients  are  startled  by  the  slightest  sound, 
and  frequently  the  sense  of  hearing  seems  to  be  highly  over- 
sensitive. 

They  are  disturbed  during  the  day  and  awakened  at  night 
by  the  slightest  and  most  ordinary  noises.  They  develop  a 
veritable  lunacy  over  street  noises,  automobiles,  fruit  peddlers, 
organ  grinders,  and.  we  are  sorry  to  record,  crying  babies. 

The  sense  of  smell  is  greatly  deranged.  The  neurasthenic 
imagines  he  detects  the  presence  of  peculiar  odors  and  bad 
smells. 

The  sense  of  taste  is  also  frequently  involved.  Foods  may 
taste  insipid,  and  the  patient  sometimes  complains  that  he  can- 
not distinguish  between  bitter  and  sweet,  nor  between  hot  and 
cold  substances  when  placed  in  the  mouth.  The  tongue  is 
usually  coated  and  the  breath  bad. 

The   sense  of  touch   is   considerablv  demoralized.      The   pa- 


THE  EAR-MARKS  OF  NEURASTHENIA  167 

tients  frequently  complain  of  transitory  increase  and  decrease 
in  skin  sensations.  They  sometimes  complain  that  while  they 
are  conscious  of  touching  an  object  with  the  hand,  that  the 
sensation  seems  to  be  obliterated  before  reaching  the  brain,  thus 
producing  a  more  or  less  haziness  as  to  the  nature  and  character 
of  the  object  touched. 

MUSCLE    MANIFESTATIONS 

While  the  leading  symptom  of  neurasthenia  is  fatigue,  and 
while  the  patient  looks  upon  this  feeling  of  weakness  as  being 
largely  a  sense  of  muscular  exhaustion,  notwithstanding  this 
apparent  nature  of  neurasthenic  fatigue,  it  must  be  recognized 
that  the  difficulty  is  largely  a  matter  of  nerve  weakness.  How- 
ever, it  is  entirely  erroneous  to  suppose  that  the  patient's  mus- 
cular weakness  is  wholly  imaginary.  To  a  large  extent,  as  far 
as  the  patient  himself  is  concerned,  this  peculiar  sense  of 
muscular  weariness  is  real. 

It  is  this  aggravating  fatigue  that  gives  origin  to  much  of 
the  patient's  peevishness,  impatience,  discontent,  and  nervous 
irritability;  all  of  which  only  tend  still  further  to  increase  the 
psychic  element  of  this  mischievous  fatigue.  The  fact  that 
a  good  night's  rest  does  not  relieve  or  remove  this  sense  of 
fatigue,  is  what  so  worries  and  frightens  the  neurasthene.  It 
has  been  my  observation  that  it  is  this  persistent  fatigue  which 
is  largely  responsible  for  creating  that  characteristic  pessimism 
of  the  neurasthene. 

Even  the  muscles  of  expression  are  afflicted  with  this  weari- 
ness, and  it  is  only  with  great  difficulty  that  the  patient  will 
permit  himself  to  indulge  in  even  the  effort  of  a  smile,  while 
hearty  laughter  is  entirely  out  of  the  question.  The  saddest 
feature  of  this  tendency  to  fatigue  is  the  ease  and  readiness 
with  which  the  patient  surrenders  to  it  —  abandoning  all  effort 
at  conquest. 

THE    MOTOR    NERVES 

Of  course  all  this  muscular  feebleness  lies  not  so  much  in 
the  muscle  itself,  as  in  the  weakness  of  the  motor  nerve  supply- 
ing it.     And  this  becomes  so  great  in  some  cases  of  nervous 


i08  WORRY  AXD  NERVOUSNESS 

prostration  that  the  patient  is  actually  unable  to  turn  over  in 
bed.  The  fact  that  this  fatigue  is  largely  a  nervous  proposition 
tends  to  explain  how  the  "  batteries  begin  to  find  themselves  " 
in  the  late  afternoon  or  early  evening  and  how  the  patient,  after 
dinner,  sometimes  feels  as  if  he  had  really  had  several  hours' 
rest. 

Of  course  these  same  irritable  motor  nerves  never  cease  to 
torment  the  patient  with  all  sorts  and  forms  of  muscular  ten- 
sion, intermittent  twitchings,  particularly  about  the  eyes,  nose, 
and  mouth,  sudden  jerking  of  the  legs  and  various  tremors. 

As  might  be  imagined,  walking  or  standing  is  peculiarly  irk- 
some to  neurasthenics.  When  compelled  to  stand  they  usually 
lean  against  something,  and  when  sitting  —  they  greatly  prefer 
rocking  chairs  —  they  either  slouch  down  in  the  chair  or  rock 
incessantly. 

DIGESTIVE   SYMPTOMS 

Thus  far  our  recital  of  neurasthenic  symptoms  has  dealt  more 
largely  with  those  nervous  disturbances  arising  in  either  the 
sensory  or  motor  mechanisms  of  the  central  (cerebro-spinal ) 
nervous  system.  We  now  come  to  the  discussion  of  those 
symptoms  originating  more  particularly  in  the  great  sympa- 
thetic system  of  nerves.  The  irritation  or  demoralization  of 
this  powerful  nervous  mechanism  directly  results  in  disturbing 
and  disordering  the  functions  of  the  digestive,  secretory,  respir- 
atory, and  circulatory  systems.     (Fig.  I.) 

Such  a  large  number  of  neurasthenics  present  digestive  dis- 
orders as  their  chief  complaint,  that  it  has  led  to  the  designation 
of  "gastric  neurasthenia."  or,  in  more  common  words  —  nerv- 
ous dyspepsia.  These  patients  have  a  variable  appetite  —  some- 
times wanting,  at  other  times  voracious.  They  often  complain 
of  a  heavy  feeling,  like  a  lump  of  lead,  at  the  pit  of  the  stom- 
ach. They  are  also  inordinately  bothered  with  gas  in  the 
stomach  and  intestines.  They  frequently  suffer  severely  from 
heartburn.  While  digestion  may  be  slow,  many  patients  are  able 
to  maintain  good  weight,  and,  as  a  result,  get  scant  sympathy 
from  their  friends  when  they  so  bitterly  complain  of  their 
stomach  troubles. 


THE  EAR-MARKS  OP  NEURASTHENIA  [6g 

These  stomach  troubles  lead  many  neurasthenics  to  live  in 
great  terror  of  being  carried  off  by  cancer  of  the  stomach. 
Many  of  these  nervous  patients  suffer  more  or  less  from  a 
tumbling  down  of  the  abdominal  organs  (enteroptosis),  and 
while  much  of  their  talk  and  worry  over  dilatation  of  the 
stomach  and  prolapse  of  the  kidney  is  largely  imaginary,  never- 
theless, when  these  patients  are  properly  fitted  with  a  suitable 
abdominal  support,  we  have  often  found,  especially  in  the  case 
of  nervous  women,  that  many  of  these  distressing  digestive 
symptoms  have  disappeared.  These  supports  often  relieve  that 
bothersome  sensation  of  '*  fluttering  in  the  abdomen,"  which 
so  many  nervous  patients  complain  of. 

The  majority  of  neurasthenics  suffer  more  or  less  from  con- 
stipation. This  condition  sometimes  alternates  with  a  mucous 
diarrhoea,  accompanied  by  all  the  terrors  of  intestinal  fermen- 
tation and  its  resultant  auto-intoxication. 

CIRCULATORY   DISORDERS 

The  palpitation  of  the  heart  from  which  neurasthenics  so 
commonly  suffer,  is  largely  the  result  of  disordered  digestion 
—  pressure  from  gas  in  the  stomach  —  although  it  may  result 
from  unusual  mental  or  muscular  efforts,  and  is  sometimes 
accompanied  by  the  most  distressing  pain  in  the  cardiac  region. 

Neurasthenics  usually  have  a  small  rapid  pulse  of  about 
ninety  to  the  minute,  and  during  these  heart  attacks  it  not 
uncommonly  reaches  one  hundred  and  forty  to  one  hundred 
and  fifty  to  the  minute.  In  advanced  cases  it  is  possible  to 
detect  even  certain  characteristic  heart  murmurs  on  close  exam- 
ination ;  and  thus  the  patient's  groundless  fears  of  heart  disease 
are  further  aroused  and  confirmed. 

The  circulation  is  always  feeble  and  unstable,  the  hands  and 
feet  are  chronically  cold,  the  patient  is  a  victim  of  intermittent 
vasomotor  storms,  localized  or  general  flushings,  throbbing 
pulsations,  abnormal  sweats,  etc.  Blushing  takes  place  with 
the  least  excitement.  In  many  cases  the  palms  of  the  hands 
are  almost  always  covered  with  a  clammy  sweat.  Many 
patients  are  plagued  with  these  manifestations  of  sweating  and 
blushing  the  moment  they  appear  in  public. 


i ;o  WORRY  AND  NERVOUSNESS 

THE  PALE  SKIN 

Over-excitation  of  the  vasoconstrictor  nerves  is  responsible 
for  the  prolonged  spasm  of  the  peripheral  blood-vessels  and  the 
resultant  pallor  of  the  skin  accompanied  by  congestion  in  one  or 
more  of  the  internal  organs.  It  is  this  sluggishness  of  the 
circulation  that  renders  the  neurasthenic  so  highly  sensitive  to 
atmospheric  changes,  especially  to  sudden  cold.  Notwithstand- 
ing this  fact,  it  is  indeed  remarkable  what  a  large  proportion 
of  these  circulatory  disorders  are  directly  due  to  and  controlled 
by  the  mental  state. 

Disturbances  in  the  circulation  are  reflexly  manifested  as 
disorders  in  secretion.  The  urine  is  usually  scant  and  highly 
colored,  because  neurasthenics  drink  too  little  water.  The  sweat 
is  sometimes  deficient,  while  in  other  cases  the  patient  may 
break  out  in  a  profuse  perspiration  upon  the  slightest  embar- 
rassment. Sudden  changes  in  the  circulation  also  result  in 
fits  of  disordered  breathing.  The  respiratory  movements  arc- 
slow  and  the  breathing  shallow. 

INSOMNIA 

We  come  now  to  the  consideration  of  the  sufferer's  nights. 
A  night  of  complete  wakefulness  may  follow  a  day  of  com- 
parative tranquillity,  whereas  a  heavy  sleep  of  seven  or  eight 
hours  may  bring  to  a  close  a  day  of  unusual  turmoil.  It  some- 
times requires  an  hour  or  two  to  get  quieted  down  and  ready 
for  sleep  after  retiring.  Meantime  the  mind  runs  like  a  mill 
race.  The  happenings  of  the  day  are  gone  over  again  and 
again  in  minutest  detail,  and  the  probable  sayings  and  doings 
of  the  morrow  thoroughly  rehearsed.  The  patient  is  very  apt 
to  awake  from  dreams  with  rapidly  beating  heart,  and  with 
body  and  limbs  quaking  and  bathed  in  perspiration.  Many 
claim  that  they  do  not  get  more  than  two  or  three  hours'  sleep 
out  of  the  twenty-four,  for  weeks  and  even  months  at  a  time. 

Fechner  has  shown  how  to  measure  the  intensity  of  the  noise 
required  to  awaken  a  person,  as  the  gauge  of  intensity  of  that 
person's  sleep.  An  instrument  has  been  devised  through  which 
the  sound  impressions  used  for  such  an  awakening  are  regis- 
tered in  the  form  of  a  curve  upon  a  cylinder.     The  sound  is 


THE  EAR-MARKS  OF  XEURASTHEXIA  171 

produced  by  a  pendulum  striking  with  varying  force  on  a 
plate,  causing  tones  of  corresponding  intensity.  These  experi- 
ments clearly  demonstrate  the  existence  of  a  typical  "  neuras- 
thenic curve,"  which  shows  that  neurasthenics  often  awaken 
too  early  in  the  morning  —  in  other  words,  their  sleep  is  inter- 
rupted by  the  slightest  sound. 

THE   CONCLUSION 

In  reciting  the  symptoms  of  neurasthenia  in  this  chapter  the 
author  does  not  pretend  that  all  have  been  noted.  Many  have 
been  omitted,  but  enough  are  here  included  to  show  what  a 
protean  disorder  nervous  exhaustion  is. 

Let  our  neurasthenic  reader  pause  and  ponder  —  let  him  note 
what  a  galaxy  of  symptoms  and  disturbances  are  herewith 
presented,  and  then  stop  for  a  moment  and  coolly  reflect  that 
he  himself  may  actually  have  all  these  symptoms  of  disease  — 
and  yet  the  only  thing  ailing  him  is  simple  neurasthenia,  a 
bunch  of  nervous  capers  which  are  not  even  permitted  to  dig- 
nify themselves  by  being  regarded  as  a  real  disease. 

Disturbances  in  the  generative  system  as  manifested  in 
neurasthenia  will  be  noted  in  a  later   chapter.      (See  chapter 

XVI.) 

Pain,  as  associated  with  neurasthenia,  is  fully  discussed  in 
the  next  two  chapters. 

SUMMARY    OF    THE    CHAPTER 

1.  The  purpose  in  reciting  the  symptoms  of  neurasthenia  is 
two-fold;  first,  to  convince  the  neurasthenic  that  his  sufferings 
are  neither  unusual  nor  unique.  Second,  to  show  that  the  doctor 
has  met  many  another  case  just  like  his. 

2.  The  cardinal  symptoms  of  neurasthenia  are :  exaggerated 
suggestibility,  oversensitiveness,  abnormal  impressibility  and 
increased  emotionalism. 

3.  The  characteristic  symptoms  of  neurasthenia  owe  their 
origin  and  existence  to  fear.  The  neurasthene  enacts  his  role  in 
the  drama  of  life  while  in  a  state  of  perpetual  stage-fright. 

4.  Psychasthenics  are  tormented  with  abnormal  thoughts,  a 
flood  of' unhealthy  feelings,  worry,  definite  dreads,  premonitions, 
and  periodical  attacks  of  the  blues. 

5.  Other  common  psychic  symptoms  are  mental  confusion, 
vagueness  of  ideas  and  emotions,  loss  of  self-confidence,  morbid 


172  WORRY  AND  NERVOUSNESS 

introspection,  nervous   irritability,   extraordinary   egotism,   and 
characteristic  fits  of  anger. 

6.  Neurasthenics  reason  superficially.  Judgment  is  hesitating 
and  ill-formed.  Capacity  for  mental  work  is  abridged.  They 
experience  frequent  "  psychic  explosions,"  and  have  a  tendency 
to  more  or  less  estrangement  from  their  loved  ones. 

7.  While  neurasthenics  are  very  sensitive  to  slights  and  neg- 
lects, they  are  very  prone  to  both  slight  and  neglect  other  people. 

8.  Common  symptoms  experienced  in  the  head  are :  constric- 
tion band  feeling,  burning  spots,  prickling,  crawling,  fullness, 
emptiness,  and  dizziness. 

9.  All  these  cerebral  symptoms  are  increased  by  mental  appli- 
cation which  in  turn  enormously  increases  other  symptoms. 
The  net  result  is  to  greatly  increase  the  patient's  ever-present 
fear  of  insanity. 

10.  The  neurasthenic  headache  is  described  as  a  sensation  of 
mildly  squeezing  the  brain,  or  one  of  pressure  on  top  of  the 
head.  It  is  worse  in  the  morning  and  grows  better  during 
the  day. 

11.  The  most  common  spinal  manifestations  are  backache, 
tender  spots,  and  a  bothersome  drawing  sensation  at  the  back  of 
the  neck. 

12.  While  the  chief  sensory  symptom  is  tiredness  or  fatigue, 
the  patient  is  also  tortured  with  sensations  of  heat,  cold,  prick- 
ling, tightness,  numbness,  stiffness,  weakness,  soreness,  pressure, 
and  wandering  neuralgic  pains. 

13.  The  vision  of  the  neurasthene  is  easily  overtaxed  by  read- 
ing. The  letters  blur  or  run  together,  specks  float  before  the 
eyes,  while  still  other  disturbances  needlessly  alarm  the  patient. 

14.  The  hearing  is  overacute.  The  patient  is  greatly  dis- 
turbed by  all  forms  of  noise,  automobiles,  peddlers,  organ  grind- 
ers, crying  babies,  etc. 

15.  The  special  senses  of  smell,  taste  and  touch  are  all  more 
or  less  deranged,  and  afford  the  patient  no  end  of  anxiety. 

16.  It  is  the  aggravating  fatigue  or  muscular  weakness  that 
produces  the  patient's  peevishness,  impatience,  discontent,  and 
nervous  irritability. 

17.  The  worst  feature  of  neurasthenic  fatigue  is  the  readiness 
with  which  the  patient  surrenders  to  it.  He  makes  little  or  no 
effort  at  resistance. 

18.  These  same  irritable  motor  nerves,  responsible  for  mus- 
cular weakness,  never  fail  to  torment  the  patient  with  all  sorts 
of  tension,  twitchings,  jerkings,  and  tremors. 

19.  The  sympathetic  nervous  system  gives  rise  to  a  very  large 
number  of  the  most  distressing  of  the  neurasthenic's  troubles,  the 
chief  of  which  is  "  nervous  dyspepsia." 


THE  EAR-MARKS  Of  NEURASTHENIA  173 

20.  Most  nervous  patients  suffer  from  chronic  constipation  as 
well  as  from  enteroptosis  —  a  general  tumbling  down  of  the 
abdominal  organs. 

21.  Among  other  circulatory  symptoms  may  be  mentioned  pal- 
pitation of  the  heart,  rapid  pulse,  unstable  circulation,  throbbing 
pulsations,  pale  skin,  abnormal  sweats,  etc. 

22.  The  neurasthenic  is  also  troubled  with  disturbances  of  the 
bodily  secretions.  The  urine  is  usually  scanty.  Sweating  may 
either  be  deficient  or  profuse. 

23.  One  of  the  neurasthene's  worst  enemies  is  his  persistent 
insomnia.    He  is  awakened  by  trifles  and  harassed  by  dreams. 

24.  And  so  it  is  possible  for  these  nervous  sufferers  to  be 
afflicted  with  an  almost  endless  variety  of  symptoms,  simulating 
all  sorts  of  disease,  and  yet  the  diagnosis  is  neurasthenia. 


CHAPTER  XIV 
FASTIDIOUS  SUFFERING  AND  IMAGINARY  PAIN 

A  CAREFUL  study  of  the  human  nervous  system  makes  it 
plain  that  the  sensations  of  sight,  sound,  and  pain  are  not 
located  or  experienced  in  the  special  sense  organs.  Here,  to 
be  sure,  the  first  step  is  taken  toward  their  arousal,  but  they 
finally  depend,  without  exception,  upon  special  activity  in  the 
cortex  of  the  cerebrum  —  the  outer  portion  of  the  upper  brain. 
These  feelings,  which  we  commonly  recognize  and  call  sen- 
sations or  pain,  result  from  the  excitation  of  certain  special 
nerves  which  end  in  the  eye,  the  nose,  the  ear,  the  skin,  and 
other  organs,  and  which,  when  stimulated,  cause  waves  of 
nervous  energy  to  pass  quickly  over  the  nerves  up  to  the  brain, 
and  it  is  only  after  these  waves  of  nerve  energy  reach  the 
brain,  and  are  there  received  and  responded  to  by  the  special 
centers,  that  the  sensations  of  sight,  sound,  pain,  etc.,  are 
experienced. 

PSYCHIC    SENSATION 

We  begin  to  see  that  an  idea,  an  experience,  a  sensation,  a 
pain,  or  even  a  disease,  may  be  wholly  unreal  —  that  it  does  not 
follow  that  an  experience  is  true  and  genuine  just  because  the 
mind  accepts  it  as  true.  The  mind  is  capable  of  almost  unlim- 
ited deception,  monstrous  imposition,  and  is  subject  to  innumer- 
able errors  of  internal  working  and  inaccuracies  of  the  thinking 
process.  But  it  must  be  remembered  that  imaginary  or  unreal 
disease  is  altogether  able  to  give  rise  to  a  vast  amount  of  real 
suffering. 

And  so  it  is  possible  for  the  body  to  originate,  and  the  mind 
to  recognize,  sensations  which  are  not  actually  present;  for 
instance,  cancer  of  the  foot  can  produce  severe  pain  for 
months;  cancer,  foot,  and  all,  may  be  amputated,  and  yet  the 

i/4 


FASTIDIOUS  SUFFERIXG  175 

patient  may  keep  on  recognizing  pain  as  coming  from  the  foot 
—  recognizing  it  as  in  the  foot — for  weeks  after  the  disea 
member  has  been  buried  in  some  distant  field. 

And  so  various  sensations  of  feeling  —  itching,  pricking, 
burning  —  as  well  as  sounds  and  voices,  sights  and  objects, 
may  be  aroused  in  the  brain,  while  in  reality  they  have  no 
existence;  they  are  merely  illusions,  sense  delusions,  or  mental 
hallucinations.  Sensations  can  produce  ideas,  and  it  should 
also  be  borne  in  mind  that  ideas  can  also  produce  sensations. 

FICTITIOUS    PAIN 

Under  certain  diseased  or  unnatural  conditions,  what  is  there 
to  hinder  the  nerves  or  nerve  centers  from  automatically  set- 
ting in  operation  waves  of  energy  or  reporting  impressions  on 
their  own  responsibility,  entirely  independent  of  the  impressions 
made  upon  the  organs  of  special  sensation,  with  which  they 
are  connected?  and,  further,  even  if  this  did  not  occur,  what 
is  there  to  prevent  the  special  brain  centers,  under  certain 
abnormal  conditions,  from  reporting  to  the  consciousness  of  the 
individual  that  they  have  received  certain  impressions  of  sight. 
sound,  or  pain,  when  in  reality  they  have  received  no  such 
impressions?  The  special  center  of  sensation  for  some  partic- 
ular sense  organ  may  automatically,  independently,  and  spon- 
taneously give  origin  to  a  false  sensation  —  that  is,  a  sensation 
which  in  that  particular  instance  did  not  have  a  definite  phys- 
ical origin.  In  this  way  arise  hallucinations,  delusions,  illu- 
sions, and  various  paresthesias ;  for  example,  a  bitter  taste 
in  the  mouth ;  as  well  as  psychic  or  fictitious  sensations  of  pain. 

And  so  it  is  found  that  the  mental  state  of  fear,  together 
with  all  its  many  phases  and  numerous  psychic  offspring,  has 
a  tendency  to  produce  unnatural  and  abnormal  sensations  or 
to  increase  their  intensity ;  and  it  may  even  torture  the  sufferer 
with  sensations  and  feelings  which  have  no  physical  founda- 
tion. Fear  and  worry  demoralize  the  nervous  mechanism  of 
the  body,  and  so  greatly  interfere  with  the  normal  and  natural 
interpretation  of  physical  impressions  and  the  recognition  of 
normal  bodily  sensations.  It  is  entirely  possible  for  the  mind  to 
recognize  an  unrealitv  as  real. 


176  ll  ORRY  AND  NERVOUSNESS 

HABIT    PAINS 

Reference  has  already  been  made  to  the  suffering  which  is 
sometimes  long  experienced  after  a  cancerous  foot  has  been 
amputated.  Patients  not  infrequently  suffer  actual  pain  for 
a  period  of  time  after  the  disease  causing  the  pain  is  effectually 
removed  —  they  get  well  —  but  the  pain  persists.  It  is  just 
such  experiences  as  these  that  have  led  physicians  and  psychol- 
ogists to  recognize  the  existence  of  the  so-called  "'  habit  pain." 

Medical  men  are  constantly  meeting  with  a  class  of  nervous 
patients  who,  on  careful  examination,  are  found  to  be  the 
unconscious  victims  of  this  so-called  "  habit  sensation,"  or,  as 
I  call  it,  u  post-convalescent  pain."  In  such  cases,  even  when 
the  actual  cause  is  removed,  either  the  nerves  continue  to  for- 
ward pain  impressions  to  the  brain,  or  the  brain  centers,  having 
become  habituated  to  reacting  to  such  impressions,  continue  to 
awaken  the  consciousness  of  pain. 

The  nervous  system  is  the  very  home  and  mechanism  of 
habit.  All  our  habits  —  good  or  bad  —  have  their  origin  and 
exigence  in  the  tendency  of  the  nerve  centers  to  duplicate, 
repeat,  and  reiterate  their  impulses:  it  is.  therefore,  little  won- 
der that  when  certain  sensations  of  pain  have  long  been  experi- 
enced—  when  their  painful  impulses  have  many  times  been 
passed  over  the  nerve  tracts  and  through  the  nerve  centers  up 
to  the  special  receiving  and  recognizing  centers  of  the  brain  — 
I  say  it  is  little  wonder  that  the  nervous  mechanism  thus 
involved  acquires  the  "  pain  habit,"  and  so  actually  continues 
to  transmit  and  recognize  these  painful  sensations  long  after 
their  original  and  exciting  causes  have  been  removed. 

PAIN   AND  THE  PSYCHIC  THRESHOLD 

The  consideration  of  '"  habit  pain  "  is  sufficient  to  demon- 
strate the  fact  that  the  concentration  of  one's  attention  on  the 
site  of  pain  is  entirely  sufficient,  first,  to  intensify  the  suffering, 
and.  later  —  even  after  the  exciting  causes  of  the  pain  are 
removed  —  to  perpetuate  the  painful  sensations.  This  sort  of 
suffering  is  sometimes  spoken  of  as  "  attention  pains." 

It  is  a  well  established  psychological  fact  that  the  threshold 


A 


a 


•hresmol  : 


e.AJUUiru 


Diagram  illustrating  the  conditions  present  when  a  sen- 
sation  is   increased   to   the   point   of   actual   pain,    causing 
-:-.nt    physical    suffering.     I.    the    normal   and    average 
threshold   of   consciousi:     -      2  -      E  sensory   stimuli 

re  being  increased  to  the  point  of  pain;  3.  waves 
increased   sensory   stimuli   recognized  as  physical   pain. 


B. 


3. 


sJlfUuTJ 


J- 


5:     "  J  5N    ;S   5 


Diagram  illustrating  habit  or  attention  pains.  1.  the 
threshold  of  consciousness:  2.  waves  of  normal  sensory 
stimuli:  3.  waves  of  abnormal  sensory  stimuli  resulting 
from  injury.  At  4.  the  painful  stimuli  have  dropped  to 
normal  level,  but  the  threshold  of  consciousness  is  - 
1  »wered  that  they  are  still  recognized  as  painful. 


C 


4-0, 


CONSCIOUSNESS 


fcJUTJTJ 


Diagram  illustrating  the  psychic  cure  of  pain  by  eleva- 
tion of  the  threshold  of  consciousness.  1.  the  threshold 
of  consciousness,  first  normal,  later  elevated;  2.  waves  of 
normal,  non-painful  stimuli :  3.  waves  of  increased  and 
painful  stimuli ;  4.  although  the  stimuli  persist  as  abnormal 
and  painful,  the  pain  is  lost  by  an  elevation  of  the 
"'  threshold." 


Fig.  7.  Diagrams  Illustrating  the  Relation,  gf  the.  -ibresliold 
of  Consciousness  to  the  Sensation  of  Pain 


FASTIDIOUS  SUFFERIXG  177 

of  one's  consciousness  may  be  either  raised  or  lowered  by  the 
concentration  of  the  attention.  The  term  "  threshold  of  con- 
sciousness "  is  in  quite  general  use  and  is  commonly  understood 
as  referring  to  that  boundary  line  which  separates  our  mental 
operations  into  the  conscious  and  subconscious.  What  we 
really  mean  is  that  we  have  a  "  threshold  of  awareness  " ;  every- 
thing above  which  we  are  conscious  of,  while  those  processes 
which  occur  below  this  so-called  "  threshold  "  are  to  us  uncon- 
scious; that  is,  we  are  unaware  of  them.  This  threshold  of 
consciousness  is  an  indefinite  and  constantly  shifting  affair. 
A  sudden  shifting  of  the  threshold  occurs  when  we  fall  asleep, 
also  when  we  wake  up. 

Let  us  represent  the  normal  threshold  of  consciousness  by 
the  straight  line  1,  in  Fig.  7,  A.  We  will  represent  normal  and 
non-painful  sensory  stimuli  by  waves  of  nervous  impulses,  as 
at  2.  At  3  these  sensory  impulses  are  so  abnormally  increased 
that  they  quickly  ascend  above  the  threshold  of  consciousness, 
and  the  individual  immediately  becomes  aware  of  the  presence 
of  pain.  This  is  the  state  of  affairs  in  all  normal  painful 
experiences. 

In  Fig.  7,  B,  we  again  illustrate  the  threshold  of  conscious- 
ness by  the  horizontal  line  1.  In  this  case  the  "threshold"  is 
normal  at  first,  but  at  4  it  drops  abnormally  low.  The  normal 
impulses  (2)  are  unrecognized  as  pain  as  in  diagram  A.  The 
increased  and  painful  stimuli  (3)  are  painfully  recognized  as 
before,  but  let  us  suppose  that  the  pain  in  this  case  is  due  to 
some  injury  or  inflammation  which  so  profoundly  affects  the 
mind  of  the  patient,  that  even  after  the  injury  has  been  healed 
or  the  disease  cured  at  4,  it  is  discovered  that  the  patient's 
attention  has  become  so  intently  focused  on  the  pain,  that  the 
"threshold  of  consciousness"  (1.)  is  materially  lowered.  In 
this  event  it  is  readily  apparent  that  the  waves  of  former  nor- 
mal and  natural  sensory  stimuli  (2.)  now  pass  far  up  into  the 
conscious  area  of  the  mind,  where  they  are  now  actually  recog- 
nized as  painful. 

And  so  we  find  that  a  lowering  of  the  "  threshold  of  aware- 
ness "  immediately  following  some  painful  experience  or  some 
siege  of  suffering,  is  entirely  sufficient  to  elevate  natural  and 


178  WORRY  AND  NERVOUSXESS 

harmless  sensory  impressions  to  the  point  where  the  mind 
recognizes  them  as  painful  —  and  this  is  nothing  more  or  less 
than  "  habit  pain,"  "  attention  pain  "  —  purely  "  psychic  pain.*' 
Fig.  7,  C,  illustrates  how  an  elevation  of  the  threshold  of 
consciousness  may  work  to  bring  about  the  psychic  cure  of 
what  would  otherwise  continue  as  bona  fide  physical  pain.  By 
taking  one's  mind  and  attention  off  some  minor  painful  sensa- 
tion, it  is  altogether  possible  to  effect  its  cure  in  just  this  man- 
ner. We  have  all  received  slight  injuries  at  times  when  our 
attention  was  occupied  or  diverted  —  and  never  felt  the  pain 
until  we  discovered  that  we  had  been  hurt.  A  careful  study  of 
the  diagrams  in  Fig.  7  will  serve  to  make  this  matter  entirely 
clear. 

ACTION    AND    REACTION 

And  so  we  begin  to  discern  that  the  state  of  the  attention  — 
the  focus  of  the  mind's  eye.  has  much  to  do  with  determining 
the  degree  of  our  sufferings.  The  neurological  optimist  may  be 
in  real  pain  but  effectually  rises  above  it  —  as  many  Christian 
Scientists  actually  do  —  by  sheer  force  of  will  and  the  moral 
determination  not  to  be  a  victim  of  the  whims  of  the  flesh. 
Such  patients  actually  rise  above  their  common  pains  by  ele- 
vating the  threshold  of  consciousness.  On  the  other  hand,  the 
nervous  pessimist  —  the  victim  of  acute  fear  and  chronic  worry 
—  by  lowering  the  threshold  of  consciousness,  soon  comes  to 
that  point  where  a  large  per  cent  of  the  ordinary  and  normal 
sensations  of  life  are  recognized  as  actual  pain  the  greater  part 
of  the  time.  But  it  must  not  be  supposed  that  "  attention  pain  " 
is  not  real.  These  psychic  sufferings  are  all  very  real  —  to  the 
patient.  True,  the  cause  of  the  pain  may  not  be  real  —  may  not 
be  literal  and  physical —  nevertheless,  when  the  threshold  of 
the  pain  consciousness  is  lowered,  the  sufferings  and  misery  of 
such  individuals  is  very  real:  in  their  minds  they  actually 
suffer  the  tortures  they  describe. 

We  never  suffer  from  agonizing  pains  unless  there  exists 
some  corresponding  disturbance  in  either  the  physical  state,' the 
nervous  mechanism,  or  in  the  level  of  the  threshold  of  con- 
sciousness.   When  we  come  to  take  into  account  this  new  factor 


FASTIDIOUS  SUFFERIXG  179 

of  psychic  awareness,  we  are  compelled  to  admit  that  all  forms 
of  pain  and  suffering  are  real ;  and  so  we  see  that  there  is  no 
such  thing  —  speaking  in  the  light  of  both  psychology  and 
physiology  —  as  an  imaginary  pain.  Pain  is  only  imaginary 
in  the  sense  that  actual  physical  impressions  are  in  no  way 
responsible  for  the  painful  sensations.  The  true  imaginary  pain 
must  have  its  origin  in  the  ideas  and  impulses  which  originate 
in  the  mind  itself;  and  even  in  these  cases  we  are  forced  to 
recognize  the  existence  of  an  underlying  morbid  mental  state; 
and  in  many  cases,  no  doubt,  this  morbid  mental  state  is  indi- 
rectly the  result  of  pre-existent  physical  disorder  in  some  part 
of  the  body. 

FORGETTING   PAIN 

While  we  may  ofttimes  say  to  a  patient,  "  There  is  little 
the  matter  with  you,  forget  your  pain  and  get  well,"  and  while 
such  advice  does  actually  cure  many  sufferers,  we  should 
remember  that  their  pain  was  probably  real  —  for  when  the 
average  individual  believes  he  is  suffering,  he  really  is  —  but 
what  our  advice  did  for  such  sufferers,  was  to  take  their  minds 
off  themselves  and  thus  to  raise  their  lowered  "  thresholds  of 
consciousness  "  to  such  a  point  that  their  former  painful  sen- 
sations are  no  longer  recognized  as  unpleasant  —  and  so  they 
are  immediately  cured. 

What  fine  expression  Seneca  gave  to  this  thought  in  his 
eighteenth  letter  to  Lucilius,  in  which  he  says: 

Beware  of  aggravating  your  troubles  yourself,  and  of  making  your 
position  worse  by  your  complaints.  Pain  is  slight  when  it  is  not 
exaggerated  by  the  idea;  and  if  we  encourage  ourselves  by  saying: 
"  It  is  nothing,"  or  at  least,  "  It  is  of  little  account,  let  us  endure  it, 
it  will  soon  be  over,"  we  render  the  pain  slight  by  thinking  it  so. 

The  Mohammedans  have  been  able  to  fix  this  beneficent  sen- 
timent more  firmly  in  their  minds  than  Christians ;  they  fear 
death  less  and  accept  with  calm  resignation  the  misfortunes 
they  cannot  avoid.  Sincere  Christians  ought  also  to  be  able  to 
submit   joyfully   to  the  decrees   of   Providence.     The   idea   of 


i8o  WORRY  AXD  XERl'OUSXESS 

necessity  is  enough  for  the  philosopher.  We  are  all  in  the 
same  situation  in  regard  to  the  things  that  are  and  to  things 
that  we  cannot  change.  The  advantage  will  always  lie  with 
him  who.  by  whatever  convictions,  is  able  to  attain  to  a  calm 
resignation. 

FASTIDIOUS    SUFFERING 

Fastidious  sufferers  comprise  those  sensitive  and  neurotic 
patients  who  are  more  or  less  constant  victims  of  a  certain 
refined  variety  of  human  affliction  which  is  characterized  by 
a  rarefication  of  suffering  and  a  nicety  of  illness  altogether 
different  from  and  wholly  unlike  the  common  everyday  sort 
of  pains  which  harass  ordinary  mortals. 

It  is  not  the  author's  purpose  lightly  to  speak  of  these  so- 
called  "  fastidious  sufferers. '*  nor  do  we  undertake  to  belittle 
their  suffering.  Although  we  speak  of  this  group  of  nervous 
patients  as  belonging  to  the  "  fastidious  class."  nevertheless, 
we  freely  recognize  the  reality  of  their  pain  and  its  accom- 
panying distress  and  unpleasant  sensations.  These  pains  are 
very  real  to  the  patient  —  independent  of  the  fact  as  to  whether 
they  have  their  real  origin  wholly  or  partially  in  the  mind  of 
the  sufferer. 

The  study  of  the  psychology  of  pain  and  suffering  compels 
us  to  recognize  the  existence  of  these  "  refined "  phases  of 
human  suffering.  The  failure  of  the  medical  profession  to 
recognize  and  deal  with  these  nervously  and  psychically  dis- 
ordered patients  has  been  largely  responsible  for  the  rapid  and 
enormous  growth  of  that  great  army  of  mental  healers,  psychic 
quacks,  and  other  mind  cure  frauds. 

It  is  now  a  settled  and  accepted  psychological  fact  that  a 
patient's  sufferings  —  the  degree  of  his  pain  and  the  quality 
of  his  distress  —  are  all  more  or  less  determined  by  the  sensi- 
tiveness of  his  nerves,  his  habits,  his  mode  of  thought,  the 
quality  of  his  perception  and  feelings  —  as  well  as  by  the  gen- 
eral state  of  the  physical  health,  taken  in  connection  with  past 
education  and  present  environment  —  all  of  which  become  fac- 
tors in  the  scheme  which  predisposes  one  to  the  likelihood  of 
becoming  some  sort  of  a  "  fastidious  sufferer." 


FASTIDIOUS  SUFFERING  181 

REFINED    PAIN 

The  pain  of  neurasthenia  is  due,  in  general,  to  just  two  groups 
of  exciting  causes:  first,  to  tired  out  nerves  —  nerve  exhaustion 
—  depletion  of  "energy  granules";  and,  second,  to  irritated 
nerves  —  nerves  chronically  poisoned  by  certain  toxic  sub- 
stances habitually  circulating  in  the  blood  stream. 

The  pains  of  these  "  constitutionally  inferior  "  and  neuras- 
thenic individuals  are  usually  manifested  in  the  form  of  certain 
characteristic  headaches,  which  have  already  been  considered. 
The  backache  and  other  pains  along  the  spinal  region  which  so 
frequently  trouble  neurasthenics  are  probably  due  to  the  con- 
dition of  the  muscles  found  in  that  locality.  They  also  suffer 
from  a  host  of  reflex  and  referred  pains  and  other  disagree- 
able sensations  which  have  their  origin  in  overworked  stomachs, 
lazy  livers,  sluggish  bowels,  and  poor  circulation. 

As  a  rule,  the  neurasthenic  describes  his  pains  in  an  orderly 
and  rational  manner.  In  the  main,  all  his  sufferings  are 
increased  by  work  and  relieved  by  rest;  however,  this  is  not 
always  true  of  certain  forms  of  headache  often  associated  with 
nervous  prostration.  These  peculiar  head  pains,  as  noted  else- 
where, are  sometimes  much  worse  in  the  morning  and  are 
greatly  relieved  by  moderate  exercise,  disappearing  in  the  late 
forenoon  or  early  afternoon. 

Before  one  has  long  had  neurasthenia,  the  threshold  of  the 
consciousness,  as  regards  pain,  generally  becomes  much  lowered, 
and  ere  long,  these  neurotic  patients  are  suffering  from  a  host 
of  "  attention  pains."  And  so,  while  there  may  be  more  or 
less  of  a  physical  or  pathological  background  to  neurasthenia, 
it  is  certainly  a  condition  in  which  the  psychical  elements  largely 
predominate ;  at  least,  the  great  weakness  and  the  ever  present 
exhaustion  on  the  occasion  of  the  least  exertion,  must  be  looked 
upon  as  being  largely  mental  or  nervous.  Soon  there  appears 
"  habit  fatigue  "  with  all  its  accompanying  sensations  and  symp- 
toms. 

NEURASTHENIC    PAINS 

The  neurasthene  will  enter  the  doctor's  office  and  begin  en- 
thusiastically  to   describe   his   terrible   sufferings,    speaking   of 


182  WORRY  'AND  NERVOUSNESS 

his  agonizing  pain  with  such  intensity  of  feeling  as  to  disclose 
his  evident  delight  and  pleasure  in  the  narration  of  his  miseries. 
The  physcian  immediately  begins  to  suspect  that  such  a  patient 
is  a  confirmed  neurasthene  or  psychasthene;  for  such  patients 
usually  take  great  pleasure  and  pride  in  the  glorification  of 
their  supposed  rare  and  unique  physical  infirmities. 

We  recently  saw  such  a  patient  who  described  a  "  frightful 
pain"  which  had  tormented  her  left  arm  for  three  years;  and 
as  she  told  of  her  "  unbearable  suffering,"  of  her  "  excruciating 
agony,"  her  face  wore  a  beautiful  smile  and  her  whole  coun- 
tenance beamed  with  delight  and  joy.  She  seemed  to  take 
supreme  satisfaction  in  being  able  graphically  and  exhaustively 
to  describe  a  pain  whose  location  and  character  she  thought 
her  physician  was  unable  to  comprehend.  As  a  general  rule, 
these  patients  who  so  earnestly  and  eloquently  describe  their 
pains  and  miseries  may  be  classified  as  neurasthenes,  and  their 
pains  may  be  regarded  as  largely  belonging  to  the  "  attention  " 
sort. 

The  interesting  thing  about  most  of  these  fastidious  pains  is 
the  fact  that  they  are  usually  described  as  being  in  some  region 
of  the  body  which  does  not  correspond  with  the  course  of  any 
nerve  tract  or  the  location  of  any  nerve  center.  The  majority 
of  these  pains,  no  doubt,  had  their  early  origin  in  connection 
with  some  actual  irritation  or  strain  of  the  nerves.  These 
peculiar  pains,  first  started  by  fatigue  and  toxemia,  are  per- 
petuated by  the  emphasis  of  the  attention  — by  greatly  lowering 
the  threshold  of  the  pain  consciousness. 

NEUROTIC  MISERIES 

As  a  rule,  these  neurotic  pains  are  quite  definite  —  they  are 
usually  described  as  neuralgic,  or  as  deep  seated  and  constant 
miseries.  They  are  often  found  in  the  joints,  or  may  be  de- 
scribed as  overlying  some  internal  organ  —  the  stomach,  liver, 
kidney,  etc.  Sometimes  these  patients  tell  of  "  steady  pains  " 
in  the  arms,  legs,  or  in  the  back. 

As  a  general  rule,  these  obsessive  patients  are  open  to  argu- 
ment regarding  the  reality  of  their  sufferings.  Not  infrequently 
they  will  admit  that  their  sufferings  are  more  or  less  imaginary, 


FASTIDIOUS  SUFFERIXG  183 

but  they  find  it  next  to  impossible  to  act  upon  such  conclusions, 
even  though  they  most  earnestly  endeavor  to  rise  above  their 
pain  and  banish  their  miseries.  These  sufferers  usually  belong 
to  the  self-centered,  selfish,  and  egotistic  class,  and  they  are 
seldom  cured  of  their  "  psychic  pains  "  until  their  attention  is 
effectually  diverted  from  themselves  to  things  more  healthy  and 
elevating. 

And  so,  while  these  pains  may  have  had  their  origin  in  a 
bona  fide  neuritis  or  some  other  actual  physical  disorder,  the 
case  is  regarded  as  one  of  fastidious  suffering  when  the  misery 
persists  long  after  the  nerve  lesion  has  been  healed  —  after  the 
physical  basis  of  the  original  disease  has  been  cured  and  re- 
moved. The  continuance  of  such  painful  sensations  after  the 
cure  of  their  original  cause,  must  be  due  to  a  combined  disorder 
of  the  powers  of  attention  and  a  lowering  of  the  threshold  of 
pain  consciousness. 

PSYCHASTHENIC   SUFFERINGS 

The  author  recently  had  a  patient  who  complained  of  a  small, 
circumscribed  spot  on  her  arm  which  felt  as  if  bees  were  all 
the  time  stinging  it.  With  an  improvement  in  general  health 
and  a  course  of  psychic  therapeutics  along  the  lines  of  the 
"  reeducation  "  of  her  will,  these  annoying  sensations  gradually 
disappeared. 

Dr.  Dana  gives  the  symptoms  in  two  cases  of  psychasthenic 
pain  as  follows : 

A  patient,  now  a  man  of  sixty,  has  for  fifteen  years  been  going 
around  on  crutches  because  he  has  so  much  pain  in  the  knees.  These 
knee-pains  are  always  present  slightly,  but  are  greatly  increased  by 
walking,  or  by  any  serious  vibrations ;  so  that  he  cannot  use  a  motor 
car  or  carriage,  and  he  travels,  whenever  it  is  possible,  by  boat.  This 
patient  is  an  educated  and  intelligent  man,  without  any  observable 
symptoms  of  hysteria.  The  most  elaborate  methods  of  physical  and 
clinical  exploration  have  failed  to  discover  anything  wrong  with  his 
knees.  He  intelligently  appreciates  the  explanation  that  his  trouble 
is  purely  an  idea  and  tries  to  follow  the  suggestion  based  on  this  line, 
without  avail.  For  he  gave  up  his  business  and  devoted  his  attention 
to  his  knees.    Naturally  he  has  "  attention  pains." 

A  woman  aged  forty,  of  good  general  health,  came  to  me  complain- 


184  WORRY  AND  NERVOUSNESS 

ing  of  pain  over  the  region  of  the  liver,  which  she  had  had  for  nearly 
three  years  continuously.  It  was  a  kind  of  pain  which  would  be 
associated  with  some  disturbance  of  the  gall-bladder.  She  had  been 
examined  in  every  possible  way  by  the  best  experts,  who  all  reached 
the  conclusion  that  it  was,  as  they  termed  it,  "  nervous."  She  had 
nothing  to  gain  by  having  the  pain,  and  seemed  earnestly  to  try  to 
raise  herself  above  it.  She  and  a  devoted  husband  worked  together 
daily  over  the  pain,  but  it  continued  obstinately  despite  every  kind  of 
a  cure,  until  the  time  when  I  saw  her.  It  then  gradually  disappeared 
under  a  course  of  educational  therapeutics  which  was  given  to  her. 
Her  pain  began  from  an  acute  local  disturbance.  It  kept  up  through 
her  attentions  to  it. 

And  so  these  fastidious  sufferers  variously  describe  their 
pains  and  sensations  as  a  jelly-like  feeling  in  the  small  of  the 
back;  deep-seated,  permanent  pains  in  various  parts  of  the 
body;  painful  lumps  in  the  throat;  various  abnormal  skin  sen- 
sations—  such  as  burning,  bursting,  pricking,  crawling,  etc. 
(quite  in  common  with  some  forms  of  neurasthenia  and  hys- 
teria). They  also  have  pains  which  affect  one  side  of  the  head, 
one  foot,  or  one  leg.  Sometimes  they  suffer  from  peculiar 
sensations  such  as  the  body  being  too  short  or  too  long;  as  well 
as  from  internal  trembling,  nausea,  dizziness,  etc. 

THE    HYPOCHONDRIAC'S    PAINS 

The  hypochondriac  is  "  set  "  in  his  ways.  It  is  quite  impos- 
sible to  reason  these  unfortunates  out  of  their  troubles.  Their 
sufferings  have  become  a  real  part  of  themselves,  and  all  efforts 
to  help  them  by  an  appeal  to  reason  is  soon  lost  —  you  can  only 
cheer  them  up  for  the  time  being.  In  the  most  pathetic  manner 
these  sufferers  will  tell  you  of  their  burning  or  prickling  hands 
while  they  tenderly  exhibit  the  suffering  member  for  your 
inspection  and  sympathy.  They  suffer  all  sorts  of  pains  such  as 
"  boiling  in  the  stomach,"  "  ice  on  the  back,"  "  bees  stinging  one 
side  of  the  head,"  "  water  running  under  the  skin,"  "  the  body 
stuffed  with  prickly  burrs,"  as  well  as  all  sorts  of  painful  sensa- 
tions in  the  various  internal  organs;  but,  as  a  rule,  the  pains 
of  hypochondria  are  not  so  definite  as  those  of  psychasthenia. 

The  hypochondriac  describes  his  pains  in  altogether  a  differ- 
ent manner  from  that  of  the  neurasthenic  and  the  psychasthenic. 


FASTIDIOUS  SUFFERIXG  185 

As  a  rule,  hypochondriacs  suffer  from  a  combination  of  morbid 
depression  and  abnormal  anxiety  —  a  sort  of  mild  and  chronic 
melancholia.  These  patients  describe  their  pains  and  sufferings 
with  great  seriousness  and  solemnity.  They  will  gravely  tell 
the  doctor  that  they  have  not  slept  a  wink  for  days  or  even 
weeks;  that  their  knee  or  shoulder  has  pained  them  constantly 
for  ten  years;  they  will  describe  their  sensations  of  bursting, 
boiling,  burning,  etc.,  and  the  spinal  region  is  a  favorite  site  for 
many  of  these  abnormal  sensations. 

The  hypochondriac  will  frequently  describe  his  sufferings 
with  a  tearful  eye;  in  fact,  their  pains  are  even  more  than  real 
—  they  are  excruciatingly  agonizing.  No  doubt,  many  of  these 
morbid  pains  and  obsessive  sufferings  really  do  have  a  literal, 
physical  basis  in  the  poorly  nourished  and  irritated  nerves  which 
are  the  result  of  chronic  autointoxication;  for  it  is  a  generally 
recognized  fact  that  most  hypochondriacs  have  been  or  are  now, 
dyspeptics  —  victims  of  chronic  constipation,  etc.  In  addition 
to  this  susceptible  physical  soil,  we  also  usually  have  a  marked 
lowering  of  the  threshold  of  the  pain  consciousness  —  an  ab- 
normal fixation  of  the  attention  on  the  physical  sensations ;  and 
thus  the  conditions  are  present  for  the  creation  of  an  ever 
increasing  and  vicious  "  pain  circle."  Such  patients  are  seldom 
cured  by  exclusive  psychic  treatment.  Like  the  neurasthenics, 
they  require  proper  physical  treatment  —  regulation  of  the  diet, 
fresh  air,  exercise,  and  the  increased  elimination  and  destruction 
of  bodily  poisons. 

TREATMENT    OF    FASTIDIOUS    PAIN 

The  following  procedures  have  been  found  exceedingly  help- 
ful in  the  author's  hands  in  the  work  of  relieving  the  physical 
agonies  of  this  class  of  patients,  and  should,  of  course,  be 
employed  in  connection  with  proper  psychic  and  systemic  treat- 
ment : 

1.  Hydrotherapy.  Many  neurasthenic  and  psychasthenic  pains 
can  be  cured  by  local  applications  of  heat  and  cold;  by 
applying  hot  fomentations  over  the  site  of  the  pain  for  a  few 
moments,  immediately  followed  by  a  brisk  rubbing  with  ice 
water  or  with  a  piece  of  ice,  then  more  heat,  etc.     Very  often 


1 86 


WORRY  AXD  XERVOUSXESS 


a  few  weeks  of  such  local  treatment,  in  connection  with  general 
tonic  measures  (electric  light  baths,  alternate  shower  baths, 
salt  glows,  etc.),  will  suffice  practically  to  cure  the  milder  types 
of  neurasthenic  pains. 

2.  Massage.  General  and  special  massage  are  of  great 
value  in  this  class  of  cases.  Like  the  use  of  hot  and  cold  water, 
scientific  massage  promotes  the  circulation  of  the  blood  and 
increases  the  nutrition  of  the  nerves.  Even  the  good,  vigorous 
rubbing  of  the  inexperienced  layman  is  often  able  greatly  to 
relieve  the  aches  and  pains  of  these  neurasthenic  and  hysteric 
sufferers. 

3.  Vibration.  We  have  seen  several  cases  of  psychasthenic 
and  hypochondriac  pain  cured  by  the  wise  and  persistent 
use  of  mechanical  vibration.  This  sort  of  treatment  seems  — 
in  addition  to  its  influence  on  the  currents  of  the  blood  and  the 
nerve  impulses  —  to  be  able  to  jog  the  ailing  tissues  out  of 
their  diseased  ruts,  to  cause  them  to  form  new  habits  and 
methods  of  life. 

4.  Electricity.  There  can  be  little  doubt  that  galvanic 
electricity  can  be  scientifically  employed  in  the  treatment  of 
these  fastidious  sufferers.  High  frequency  and  other  forms 
of  electricity,  while  they  may  possess  some  remedial  power, 
are  largely  psychic  in  their  effect  upon  the  patient.  The  more 
faith  the  patient  has  in  these  forms  of  electricity  the  more  good 
they  will  do  them. 

SUMMARY    OF    THE    CHAPTER 

1.  While  sensations  are  aroused  in  the  special  sense  organs, 
in  reality  they  are  experienced  or  "  felt  "  in  the  special  centers  of 
the  brain. 

2.  Sensations,  pains,  or  even  disease,  may  be  wholly  psychic  — ■ 
unreal,  and  yet  be  able  to  produce  a  vast  amount  of  real  suffering. 

3.  Pain  may  be  entirely  fictitious.  The  brain  centers  have 
power  to  fool  you.  They  are  able  to  report  feelings  and  sensa- 
tions which  have  no  physical  basis. 

4.  "  Habit  pain  "  is  that  form  of  suffering  which  persists  after 
all  actual  causes  are  removed.  It  is  a  sort  of  "  post-conva- 
lescence "  pain. 

5.  "Attention  pains "  are  those  miseries  which  result  from 
concentrating  the  mind  on  some  trifling  sensation,  thereby 
greatly  lowering  the  "  threshold  of  consciousness  "  for  pain. 


FASTIDIOUS  SUFFERIXG  187 

6.  A  lowering  of  the  "  threshold  of  consciousness  "  following 
some  siege  of  suffering  enables  ordinary  sensory  impressions  to 
ascend  up  into  the  consciousness  to  a  point  where  they  are  recog- 
nized as  pain. 

7.  The  neurological  optimist  may  rise  above  his  pain  by  elevat- 
ing the  "  threshold;  "  while  the  nervous  pessimist  by  lowering 
the  "  threshold "  actually  turns  the  normal  sensations  into 
"  attention  pain." 

8.  All  pain  is  real  —  bona  fide.  The  fact  that  it  is  psychic  in 
origin  nowise  detracts  from  its  painfulness. 

9.  Christian  Scientists  and  Mohammedans,  as  well  as  the 
devotees  of  numerous  other  cults  and  religions,  are  able  to  divert 
the  attention  away  from  pain  and  thus  contribute  directly  to  its 
cure  by  thus  elevating  the  threshold. 

10.  "  Fastidious  sufferers  "  comprise  those  neurotic  individuals 
who  are  constant  victims  of  a  sort  of  refined  variety  of  human 
affliction. 

11.  It  was  the  failure  of  physicians  to  recognize  and  relieve 
these  "  fastidious  sufferers  "  that  gave  rise  to  such  a  great  army 
of  mental  healers,  psychic  quacks,  and  mind-cure  frauds. 

12.  The  '"  refined  pain  "  of  neurasthenia  is  largely  due  to  two 
causes :  overworked  nerves  and  overirritated  nerves. 

13.  In  neurasthenia  the  threshold  for  pain  is  always  greatly 
lowered.  This  accounts  for  the  presence  of  so  many  "  attention 
pains." 

14.  These  sort  of  pains  are  so  real  to  the  neurasthene  and  the 
psvchasthene,  that  they  often  describe  them  as  "  frightful,"' 
"  agonizing."  "  unbearable,"  and  "  excruciating." 

15.  While  the  neurasthene  is  often  willing  to  admit  the  psychic 
origin  of  his  sufferings,  nevertheless  he  is  seldom  cured  of  his 
habit  pains  until  his  attention  is  effectually  diverted  from 
himself. 

16.  These  refined  sort  of  pains  are  varied  in  character  as  well 
as  location,  and  are  usually  only  cured  by  painstaking  efforts 
along  the  line  of  re-educational  therapeutics. 

17.  Hypochondriacs  complain  of  "boiling  in  the  stomach," 
"  ice  on  the  back,"  "  bees  stinging,"  and  "  water  running  under 
the  skin,"  and  are  the  most  difficult  cases  of  rarefied  suffering 
to  cure. 

18.  These  nervous  sorts  of  suffering,  in  addition  to  their 
psychic  base,  are  frequently  augmented  by  constipation  and  its 
resultant  auto-intoxication. 

19.  In  addition  to  suitable  psychotherapeutics,  the  majority  of 
these  nervous  sufferers  are  greatly  benefited  by  appropriate 
hydrotherapy,  massage,  electricity,  etc. 


CHAPTER  XV 

THE   MISSION   OF   SUFFERING  AND   THE  PURPOSE 

OF  PAIN 

THE  mission  of  pain  is  that  of  a  friendly  sentinel.  Physical 
suffering  is  designed  primarily  to  play  the  role  of  a  warn- 
ing messenger,  and,  subsequently,  to  serve  as  a  corrective 
monitor.  Pain  must  never  be  regarded  as  an  arbitrary  punish- 
ment—  as  a  manifestation  of  the  wrath  of  the  gods.  Pain  is 
nothing  more  or  less  than  an  expression  of  the  displeasure  or 
weakness  of  the  nervous  system.  It  is  the  outcry  of  the  physical 
conscience  against  disease-causes,  nervous  states,  and  bodily 
abuses,  designed  to  warn  us  of  imminent  danger  and  weakness 
or  to  protect  us  from  some  impending  doom. 

THE  VOICE  OF   PAIN 

Pain  and  suffering  come  upon  us  as  a  natural  consequence 
of  inheriting  weak  nerves,  irritating  the  brain,  or  poisoning  the 
nerves.  Pain  is  simply  a  physiological  warning,  a  psychological 
monitor,  designed  by  nature  to  lead  us  away  from  the  paths  of 
disease  and  danger.  The  voice  of  pain  should  never  be  lightly 
regarded.*  The  language  of  suffering,  when  properly  inter- 
preted, tells  of  wrong  habits,  disordered  nerve  states,  unwhole- 
some practices,  unsanitary  surroundings,  and  yields  an  eloquent 
warning  designed  to  reform  the  sufferer  —  to  cause  him  to  make 
speedy  amends.  In  fact,  the  real  mission  of  all  pain  and  suffer- 
ing is  to  lead  the  sinner  to  that  place  where  he  will  "  cease  to 
do  evil  and  learn  to  do  well."  Warnings  of  pain  are  designed 
by  nature  to  prevent  suffering,  and  suffering,  after  it  has  come 
upon  us,  is  usually  nothing  more  or  less  than  our  own  trans- 
gressions (and  those  of  our  ancestors)  transposed  into  nature's 
penalty. 

*  The  special  pains  and  sensations  of  the  neurasthenic  states  were 
fully  considered  in  the  preceding  chapter. 

188 


SUFFERIXG  AXD  PURPOSE  OF  PAIX  189 

The  voice  of  pain  is  reformatory  in  its  purpose  and  the 
language  of  disease  is  corrective  in  its  mission ;  but  it  is  a  com- 
mon practice,  when  pain  has  raised  its  voice  in  eloquent  protest, 
warning  us  of  the  dangers  besetting  our  course,  for  us  to  regard 
this  beneficence  of  nature  by  resorting  to  the  use  of  some  pow- 
erful pain-killer  or  to  some  popular  patent  poison  which  quickly 
serves  to  silence  these  friendly  voices  of  pain,  while  it  in  no 
wise  works  to  remove  the  cause,  and  thereby  bring  about  a 
rational  and  permanent  cure. 

While  it  is  true  that  pain  must  be  relieved  when  it  is  of  great 
severity  or  long  continued,  while  it  is  true  that  life  itself  is 
sometimes  dependent  on  our  ability  to  stop  suffering,  neverthe- 
less, before  resorting  to  the  use  of  these  powerful  pain  rem- 
edies, which  are  usually  composed  of  deceptive  and  dangerous 
habit-forming  drugs,  it  certainly  would  be  the  better  part  of 
wisdom  to  give  a  thorough  trial  to  such  effective  measures  as 
heat,  light,  massage,  rest,  and  other  natural  agencies,  which 
will  be  more  fully  dealt  with  later  on,  and  which  are  often  so 
highly  successful  in  both  the  relief  and  the  cure  of  even  the 
most  severe  and  chronic  forms  of  pain.  In  this  way  we  are 
able  to  avoid  the  unpleasant  and  disastrous  results  which  not 
infrequently  attend  the  use  of  these  popular  pain-killers,  so 
many  of  which  often  contain  cocaine,  opium,  morphine,  and 
other  deleterious  drugs. 

THE    PURPOSE    OF    AFFLICTION 

It  may  safely  be  said  that  the  wise  purpose  of  suffering  and 
affliction  is  to  produce  repentance  and  reform ;  and  yet,  we  are 
often  called  upon  to  endure  severe  and  long  continued  physical 
affliction  under  such  conditions  as  render  it  exceedingly  difficult 
to  discover  the  exact  transgression  which  is  directly  responsible 
for  our  misery.  Our  inability,  thus  always  directly  to  discern 
the  sin  which  is  immediately  responsible  for  the  suffering,  is,  no 
doubt,  in  some  measure  at  least,  due  to  that  lenient  practice  — 
that  merciful  habit  of  nature  —  manifested  in  holding  back,  as 
it  were  for  a  time,  the  just  penalty  of  nearly  all  our  sins  against 
her.  I  refer  to  the  interval  which  always  occurs  between  seed- 
time and  harvest.    In  this  way  Mother  Nature  gives  the  physical 


1 9o  WORRY  AXD  XERVOUSXESS 

sinner  an  opportunity  to  repent  of  his  wrong  practices  a  long 
time  before  the  full  harvest  of  his  transgression  breaks  upon 
his  defenseless  head;  but  when  her  patient  forbearance  fails 
to  bring  about  repentance  and  thus  lead  to  reform,  there  is  but 
one  thing  more  for  nature  to  do,  and  that  is  to  withdraw  her 
sustaining  arm  of  vital  resistance  and  allow  the  physical  sinner 
to  reap  the  full  harvest  of  suffering  which  springs  up  from  the 
seeds  of  his  own  wrong  doing.  Again,  as  will  be  shown  later 
on,  the  neurasthenic  not  infrequently  is  made  to  suffer  as  a 
result  of  the  sins  of  his  wrong-doing  ancestors. 

There  can  be  but  little  doubt  that  nature  has  wisely  arranged 
that  our  suffering  shall  ordinarily  constitute  her  last  corrective 
appeal  designed  to  turn  our  feet  from  the  path  of  disease  into 
the  highway  of  health  —  to  save  the  physical  sinner  from  the 
ultimate  destruction  attendant  on  his  continuance  in  sin.  In- 
deed, this  teaching  regarding  the  purpose  of  affliction  is  a  very 
ancient  one,  for  it  was,  we  believe,  the  prophet  Jeremiah  who 
wrote,  "  Thine  own  wickedness  shall  correct  thee  and  thy  back- 
slidings  shall  reprove  thee."' 

SOWING    AND    REAPING 

Within  every  physical  and  mental  transgression,  within  every 
violation  of  the  laws  of  life,  within  every  compromise  of  the 
laws  of  health,  there  is  concealed  the  seed  of  bodily  disease, 
nervous  disorder,  and  physical  suffering;  but  time  is  required 
for  the  seeds  of  sin  to  bring  forth  their  harvest,  first  of  pain, 
then  of  suffering  and  disease,  and,  in  the  end  —  if  the  corrective 
mission  of  these  should  fail  —  destruction  and  death. 

In  every  act  of  life  the  reaping  is  really  contained  in  the 
sowing,  and  while  there  is  invariably  a  delay  between  the  seed- 
time and  the  harvest,  it  is,  nevertheless,  unerringly  true  that 
"  Whatsoever  a  man  soweth,  that  shall  he  also  reap."  But 
combined  mercy  and  wisdom  are  shown  in  the  fact  that  nature 
usually  first  flashes  to  the  individual  her  warning  signal  of 
pain,  and,  after  that,  even  when  the  full  harvest-penalty  of  our 
sin  descends  upon  us  as  the  result  of  our  persistent  transgres- 
sion, even  then,  all  this  resultant  suffering  is  largely  corrective 
and  curative  in  its  effect  upon  the  body.     In  the  earlier  stages, 


SUFFERIXG  AXD  PURPOSE  OF  PAIX  191 

at  least,  most  of  the  acute  disorders  are  usually  self-limited,  cor- 
rective, and  curative. 

The  warning  role  of  pain  and  the  corrective  mission  of  suf- 
fering may  well  be  illustrated  by  a  common  experience  which 
most  of  us  have  passed  through  at  one  time  or  another  in  our 
lives  —  the  common  accident  of  putting  one's  hand  on  a  hot 
stove.  The  pain  immediately  felt  causes  one  quickly  to  remove 
the  hand,  and  who  can  but  recognize,  in  view  of  its  threatened 
destruction,  that  this  intense  and  immediate  pain  is  the  kindest 
possible  feeling  which  nature  could  dispatch  to  the  conscious- 
ness. Under  such  circumstances,  pain  can  only  be  looked  upon 
as  a  warning  voice  calling  upon  one  to  take  immediate  action 
to  save  the  threatened  member.  In  fact,  were  it  not  for  the 
restraining  influence  of  physical  pain,  untold  thousands  of  self- 
ish and  heedless  mortals  would  quickly  plunge  themselves  into 
all  manner  of  sinful  indulgences  —  soul  and  body  destroying 
practices  —  which  would  speedily  terminate  their  individual 
existence,  and,  ultimately,  threaten  even  the  integrity  of  the 
whole  human  race. 

Even  the  blister  which  was  raised  upon  the  burned  hand  is 
more  or  less  of  a  corrective  and  curative  process.  The  blister 
is  nature's  first  effort  to  correct  the  results  of  the  burn,  and,  as 
far  as  possible,  to  encourage  the  healing  of  the  wound  by  the 
formation  of  new  skin  underneath.  These  reparative  proc- 
esses are  protected  by  the  blister  overhead  with  its  neutral 
water  bath  underneath ;  indeed  this  is  an  ideal  process,  pro- 
vided the  water  that  is  contained  in  the  blister  does  not  become 
infected  by  microbes  and  thus  lead  to  the  formation  of  pus. 
In  this  latter  event,  it  would  be  better  if  the  blister  had  been 
pricked  and  suitable  artificial  dressing  applied. 

CAUSE   AND   EFFECT 

Every  genuine  physical  pain  is  the  effect,  directly  or  indi- 
rectly, of  some  physical  cause.  The  mission  of  pain  and  the 
language  of  disease,  represent  a  chapter  in  human  experience 
but  little  studied,  but  little  understood,  and,  as  a  general  rule, 
grossly  misinterpreted.  Too  often  the  sufferer  is  wholly  unable 
to  read  the  handwriting  of  disease  and  distress  on  the  walls 


192  WORRY  AND  NERVOUSNESS 

of  his  own  living  temple.  The  average  sufferer  stands  in  great 
need  of  a  physiological  Daniel  to  interpret  this  handwriting  of 
disease  on  the  walls  of  the  body.  The  civilized  races  are  ex- 
ceedingly slow  in  coming  to  recognize  that,  in  a  general  way,  all 
matters  of  health  and  disease  are  controlled  by  the  inexorable 
laws  of  cause  and  effect  —  of  sowing  and  reaping. 

The  time  has  come  when  intelligent  men  and  women  should 
understand  how  quickly  to  translate  the  voice  of  pain  into 
terms  of  transgression,  how  intelligently  to  interpret  the  lan- 
guage of  disease  into  acts  of  reform.  How  long  before  the 
world  will  come  to  understand  that  true  relation  between  sin 
and  suffering,  to  understand  that  suffering  is  an  effect  and  sin 
the  cause.*  How  long  before  we  shall  finally  and  forever  be 
delivered  from  that  ancient  and  superstitious  nonsense  so  com- 
monly expressed  in  the  modern  funeral  sermon  which  lays  the 
blame  for  disease  and  death  upon  an  all  wise  God  by  affirming 
that  the  loved  one  was  removed  from  our  midst  by  a  "  mysteri- 
ous dispensation  of  Providence." 

Indeed,  it  would  seem  that  men  and  women  with  ability  to 
discern  the  handwriting  of  disease  and  interpret  the  language 
of  suffering  have  always  been  scarce  upon  the  earth,  for  even 
in  the  time  of  Job  the  afflicted,  it  was  said  of  the  one  Who 
would  be  able  to  show  him  the  significance  of  his  suffering  and 
the  mission  of  his  misery  —  it  was  said  of  such  a  messenger 
or  interpreter  —  that  he  was  "  one  among  a  thousand."  True, 
Job  had  many  so-called  comforters,  but  none  were  able  to  help 
him  in  deciphering  the  meaning  of  his  troubles,  to  learn  the 
way  out  of  his  sorrows ;  so  much  so,  that  it  was  said  of  the 
one  that  was  able  "  to  show  unto  man  what  is  right  for  him," 
that  he  was  "  one  among  a  thousand." 

ACUTE  AND  CHRONIC  DISEASE 

We  have  alluded  to  the  experiences  of  suffering  and  the 
processes  of  disease  as  being  both  corrective  and  curative,  and 
while  this  is  largely  and  strictly  true  of  acute  disease,  it  is 
not  altogether  true  of  chronic  disease.     It  is  only  while  disease 


*  The  role  of  heredity  in  the  causation  of  the  nervous  disorders 
was  fully  considered  in  chapter  n. 


SUFFERING  AND  PURPOSE  OF  PAIX  193 

is  in  its  earlier  or  acute  stage  that  it  is  ordinarily  curative.  In 
these  earlier  stages,  in  general,  acute  disease  may  be  looked 
upon  as  an  effort  of  nature  to  cure,  and  what  we  commonly 
regard  as  disease  is  simply  the  reaction  phenomenon  which  re- 
sults from  nature's  wonderful  efforts  to  restore  the  body  to 
a  normal  and  natural  state;  but  if  the  habits  of  living  are  not 
corrected,  if  the  exciting  and  irritating  causes  of  acute  disease 
are  not  abated,  if  the  acting  causes  of  nature's  warning  are 
not  removed,  then,  in  the  later  or  chronic  stages,  the  disease 
usually  becomes  a  process  of  degeneration  and  destruction  in 
its  effect  upon  mind  and  body,  and,  ultimately,  it  assumes  the 
role  of  a  chronic,  organic,  or  incurable  disease. 

And  so,  while  in  the  acute  stage  of  most  diseases,  nature  is 
ordinarily  able  to  cure  the  ailment  more  or  less  completely  by 
her  unaided  efforts  when  the  exciting  cause  is  removed,  it  is 
altogether  different  in  the  realms  of  chronic  or  organic  disease, 
for  here,  even  after  the  original  causes  have  apparently  all 
been  removed,  health  is  usually  regained  only  by  a  process 
of  persistent  cultivation:  or  it  may  be  discovered  that  the  dis- 
ease has  taken  on  the  form  of  an  obstinate,  chronic,  and  incur- 
able malady. 

THE  FELLOWSHIP  OF  SUFFERING 

All  the  world  has  been  baptized  into  the  fellowship  of  physical 
suffering.  Love  and  sympathy  have  often  been  conceived  in 
pain  and  born  of  sorrow.  Love  is  sometimes  stronger  than  the 
protest  of  pain,  as  shown  by  the  ease  with  which  the  mother- 
love  so  many  times  overrules  pain  and  overrides  suffering.  The 
willingness  to  suffer  for  one's  friend  has  come  to  be  regarded 
as  the  token  of  loyalty,  as  the  pledge  of  fidelity. 

But  even  though  there  be  much  of  moral  and  spiritual  good 
in  our  common  experience  of  pain  and  suffering,  nevertheless 
we  should  recognize  that  we  receive  this  good  not  as  a  direct 
result  of  suffering,  but  rather  in  spite  of  suffering,  because 
of  the  noble  manner  in  which  we  may  bring  our  characters  to 
react  to  these  infirmities  of  the  flesh.  There  is  probably  no 
great  good  to  be  derived  from  pain  and  physical  suffering 
which  could  not  be  obtained  equally  well  from  the  sensations 


194  WORRY  AND  NERVOUSNESS 

of  pleasure  and  the  impulses  of  health  —  if  we  ourselves  only 
possessed  normal  minds  and  healthy  bodies. 

Endurance  is  essential  to  pleasure,  and  since  pain  ofttimes 
increases  our  endurance,  it  adds  subsequently  to  the  sum  of 
our  pleasure ;  and  so,  while  we  recognize  the  beneficent  mis- 
sion of  pain  and  distress  and  nature's  wise  purpose  in  suffer- 
ing, nevertheless,  we  would  not  prolong  human  misery  or  add 
to  the  sum  of  mortal  suffering  just  because  these  unpleasant 
experiences  have  shown  themselves  able  under  certain  cir- 
cumstances to  contribute  indirectly  to  the  development  of  a 
strong  and  noble  character. 

We  certainly  do  discover  that  pain  disciplines  the  wayward, 
corrects  the  erring,  subdues  the  proud,  warns  the  headstrong, 
and  makes  wise  the  ignorant ;  it  also  generates  social  sympathy, 
even  leading  the  rich  who  have  suffered  to  have  sometimes  a 
fellow  feeling  for  the  poor  who  now  suffer.  But  not  always 
do  we  see  this  last  salutary  effect  as  the  result  of  distress;  men 
too  quickly  forget  their  suffering  when  the  agony  is  past  and 
the  pleasures  of  living  are  theirs  once  more  to  enjoy. 

And  too,  it  must  be  remembered  that  nature  shows  little 
discrimination  in  the  distribution  of  her  penalties ;  whether  the 
nights  have  been  spent  in  dissipation  and  debauchery  or 
whether  they  were  spent  in  watching  at  the  bedside  of  the 
sick  and  suffering  child  by  a  deserted  mother;  in  the  end, 
the  penalties  for  over-exertion  and  loss  of  sleep  are  exacted 
by  nature  quite  regardless  of  whether  the  sin  was  one  of 
selfishness  and  for  one's  own  pleasure,  or  for  the  good  of 
another  —  a  labor  of  love. 

THE   RESULTS   OF   SUFFERING 

The  experience  of  long  continued  pain,  the  results  of  un- 
usual sorrow  or  special  suffering  produce  certain  permanent 
effects  upon  the  character  of  all  who  are  thus  afflicted  —  they 
either  sweeten  or  sour  the  disposition.  Pain  never  fails  to 
harden  or  to  melt,  suffering  either  closes  or  opens  the  heart. 
Pain  makes  the  sufferer  either  more  sympathetic  or  more  cal- 
lous towards  the  suffering  of  others.  And  so,  although  pain 
in  and  of  itself  is  not  a  thing  to  be  desired,  it  does  sometimes 


SUPFERIXG  AXD  PURPOSE  OF  PAIX  195 

serve  a  valuable  two-fold  purpose  of  saving  us  from  the 
dangers  of  which  it  is  a  warning,  and,  not  infrequently,  of 
making  us  all  the  better  in  spite  of  our  suffering. 

Indeed,  pain  and  suffering  are  somewhat  like  the  bramble 
bush  on  either  side  of  the  road,  hedging  us  up  on  both  sides 
for  the  wise  purpose  of  keeping  us  steadily  moving  forward  in 
the  middle  of  the  highway  of  health  and  happiness.  And  so 
we  see  there  come  up  for  consideration  many  problems  in 
connection  with  the  purpose  and  mission  of  pain,  and  while 
our  capacity  for  suffering  is  certainly  more  or  less  a  matter 
of  nervous  susceptibility,  we  are  compelled  to  recognize  that 
a  degree  of  our  misery  is  also  somewhat  determined  by  our 
mental  and  moral  attitude. 

The  fact  that  we  usually  regard  painful  experiences  as  evil 
and  pleasurable  experiences  as  good  has  no  doubt  had  much 
to  do  with  determining  the  moral  and  spiritual  value  of  pain 
and  suffering  in  the  lives  of  many  persons. 

RACIAL    SUFFERING 

There  is  much  of  pain  and  suffering  which  one  is  sometimes 
called  upon  to  endure  which  is  not  entirely  due  to  the  indi- 
vidual's personal  disobedience.  We  must  recognize  that,  in 
this  life,  it  is  the  weak  as  well  as  the  wrong  who  are  pun- 
ished. If  through  a  long  line  of  miserable  heredity  we  are 
born  into  this  world  physically  or  neurologically  bankrupt,  it 
is  self  evident  that  such  physical  weaklings  are  doomed  to 
suffer  more  than  their  share  of  pain  and  misery.  Even  the 
fact  that  we  are  born  a  member  of  a  certain  race,  the  fact  that 
our  lives  are  forced  to  be  spent  in  certain  quarters  of  the  earth, 
these,  together  with  numerous  other  climatic,  social,  industrial, 
and  other  reasons  conspire  to  determine  more  or  less  our  degree 
of  pleasure  and  suffering  in  this  life. 

And  so,  while  it  is  in  a  general  way  true  that  pain  is  the 
minister  of  justice  to  the  individual,  nevertheless,  we  certainly 
suffer  many  things  as  a  result  of  the  sins  of  past  generations; 
and  it  is  literally  true,  that  it  is  the  weak  as  well  as  the  wicked 
who  are  called  upon  to  suffer  while  passing  through  this  so- 
called  vale  of  tears. 


196  WORRY  AND  NERVOUSNESS 

THE  PERSONAL  FACTOR   IN   PAIN 

Transitory  pains  are  often  caused  by  excessive  or  unnatural 
stimulations  of  some  part  of  the  body  reflexly  associated  with 
the  nerves  which  manifest  the  pain,  while  a  natural  and  nor- 
mal stimulation  of  these  same  bodily  parts  or  organs  would 
have  resulted  in  pleasure.  It  is  manifestly  impossible  always 
satisfactorily  to  differentiate  between  pain  and  pleasure.  These 
two  diverse  and  entirely  different  sensations  are  very  close 
of  kin,  and  as  to  whether  a  given  stimulation  or  excitation  of 
the  nerve  results  in  pain  or  pleasure,  is  to  be  entirely  deter- 
mined by  the  degree  of  intensity  of  the  stimulation,  as  well  as 
by  the  physical  state  of  the  nerve  and  the  mental  state  of  the 
individual. 

And  so  there  is  one  thing  certain  about  pain,  whatever  may 
be  the  exciting  cause,  both  pain  and  pleasure  are  largely  per- 
sonal and  relative.  They  do  not  as  a  rule  represent  definite 
and  fixed  states  either  mentally  or  physically.  The  personal, 
physical  and  psychical  equation  has  much  to  do  with  determin- 
ing the  nature  and  degree  of  painful  sensations. 

Shakespeare  said,  "  one  pain  is  lessened  by  another  anguish." 
We  seldom  feel  two  pains  at  the  same  time.  There  is  literally 
a  limit  to  the  amount  of  pain  which  the  mind  can  recognize. 

PAIN   A   DANGER   SIGNAL 

As  we  proceed,  we  shall  find  more  and  more  that  of  all  the 
sensations  which  we  experience,  pain  is  indeed  our  best  friend, 
for  it  comes  to  be  our  very  best  teacher.  We  must  get  away 
from  the  old  idea  that  pain  is  a  thing  always  to  be  despised 
and  lightly  regarded;  w^e  must  overcome  the  notion  that  pain 
is  an  arbitrary  interference  with  the  normal  and  natural  pleas- 
ures of  living.  Pain  is  just  as  much  a  necessary  part  of  life 
as  all  the  methods  of  corrective  discipline  and  the  necessity 
for  study  are  essential  to  the  success  of  an  educational  institu- 
tion. In  fact,  when  we  come  to  understand  all  the  relation- 
ships of  the  case,  we  are  compelled  to  look  upon  suffering  as  a 
friend  and  not  as  an  enemy;  that  is,  the  mature  results  of  suf- 
fering to  the  human  race  — if  suffering  were  properly  inter- 
preted and  pain  rationally  understood  —  would  be  positively  for 


^  V 


*~  % 


•  :-w^ 


Railroad  Wreck.  Result  of  Failure  to  Stop  for  the  Red  Light 
Danger  Signal 


Courtesy   of  "  The  Modem   Hospital  " 

Surgical  Operation.  Sometimes  the  Result  of  Failure  to  be  Admon- 
ished by  the  Danger  Signal  of  Pain 

FIG.  8.  THE  RESULTS  OF  DISREGARDING  "DANGER 
SIGNALS  " 


SUFFERIXG  AND  PURPOSE  OF  PAIN  197 

good  and  not  for  evil ;  and  that  such  is  the  case  is  well  shown 
by  the  common  experience  of  the  surgeon,  who,  while  he  recog- 
nizes suffering  and  constant  pain  in  the  abdomen  as  indicative 
of  grave  danger,  also  recognizes  as  far  more  grave  and  danger- 
ous the  sudden  disappearance  of  that  pain,  which  suggests  to 
his  mind  an  internal  catastrophe  —  probably  the  rupture  of  some 
diseased  organ  and  the  consequent  spreading  of  infection 
throughout  the  abdomen  —  with  its  probable  fatal  termination. 
(Fig.  8.) 

Pain  is  indeed  a  danger  signal  —  an  automatic  and  ever  act- 
ing system  of  alarm  wires  which  are  everywhere  stretched  out 
over  the  vast  domain  of  the  physical  body  —  always  ready  to 
catch  the  least  suspicion  of  danger  and  disease  and  flash  the 
warning  in  no  uncertain  terms  to  the  brain,  the  citadel  of 
intelligence  and  action,  from  whence,  if  the  warning  messages 
of  pain  are  properly  deciphered  and  comprehended,  the  orders 
may  be  dispatched  to  withdraw  the  body  from  the  zone  of 
danger  or  to  reform  the  unwholesome  practices  which  threaten 
disease  or  disaster.  (Fig.  8.)  And  so,  while  pain  is  at  first 
a  warning  signal  of  danger,  it  may  later  become,  if  unheeded, 
a  disease  indicator,  a  symptom  of  the  very  thing  which  it 
was  originally  designed  to  prevent  and  warn  you  away  from. 
And,  as  has  already  been  shown,  false  sensations  of  pain  may 
arise  from  causes  which  are  purely  imaginary  and  wholly 
fictitious. 

THE   PHYSICAL    CONSCIENCE 

We  are  compelled  to  regard  all  ordinary  sensations  of  fatigue 
and  pain  as  friendly  voices  of  warning.  Pain  in  the  long 
run,  if  properly  understood,  becomes  a  powerful  pleasure  pro- 
moter. Our  unpleasant  and  disagreeably  painful  sensations  may 
indeed  be  looked  upon  as  constituting  the  "  physical  conscience  " 
of  the  body,  ever  promptly,  effectively,  and  persistently  warn- 
ing both  the  ignorant  and  the  heedless  against  the  folly  of 
continuously  disregarding  the  laws  of  nature.  Painful  sen- 
sations are  indeed  the  pathetic  prayer  of  the  nerve  for  rest, 
relief,  or  recreation. 

Recont  investigations  as  to  the  cause  of  suffering  go  to  show 


198  WORRY  AXD  XERl'Ol'SXESS 

that  a  great  deal  of  pain,  or  predisposition  thereto,  is  occa- 
sioned by  an  unhealthy  state  of  the  blood  stream.  In  fact,  one 
authority  has  denned  pain  as  the  "  prayer  of  the  nerve  for 
healthy  blood."  Even  physical  fatigue  is  largely  due  to  the 
presence  of  these  poisons  in  the  blood,  and  there  can  be  little 
question  that  actual  pain  in  many  instances  is  merely  a  sort  of 
local  protest  of  the  body  against  the  unnatural  poisonous  state 
of  the  blood  which  is  circulating  throughout  the  system. 

PAIN   AN   AUTOMATIC  SPEED  REGULATOR 

Painful  sensations  are  nature's  automatic  speed  regulator. 
We  sometimes  suffer  merely  because  our  body  machine  is 
proceeding  through  life  at  too  great  a  pace.  The  one  promi- 
nent characteristic  of  our  present-day  social  and  commer- 
cial life  is  its  high  tension.  Everybody  is  keyed  up  to  the  last 
notch.  People  are  living  at  a  fierce  pace,  and  the  pressure- 
gauge  of  life  registers  all  the  while  dangerously  near  the  burst- 
ing point.  Just  as  the  smoke  warns  the  trainmen  of  the  hot 
box  and  serves  immediately  to  bring  his  mind  to  the  dangers 
attendant  thereon,  so  pain  is  sometimes  designed  to  admonish 
us  of  the  dangers  of  frenzied  and  foolish  living.  Xo  automo- 
bilist  would  dare  heedlessly  to  drive  his  machine  forward  with  a 
shrieking  axle  or  a  rattling  wheel  unless  his  journey  was  actu- 
ally one  of  life  and  death;  and  yet  how  often  we  observe  men 
and  women  forcing  their  body  machines  forward  under  the  lash 
of  unnatural  stimulation,  while  they  deaden  the  accompanying 
protest  and  warning  of  pain  with  strong  drugs  and  powerful 
narcotics.  Not  infrequently  these  hygienic  "  high-speeders " 
come  to  look  upon  the  ability  either  to  experience  or  silence 
pain  as  a  real  virtue  —  as  an  evidence  of  superior  wisdom  or 
unusual  strength  of  character. 

While  pain  undoubtedly  is  greatly  increased  by  morbidly 
fastening  one's  attention  upon  it;  nevertheless,  it  is  an  experi- 
ence which  ultimately  demands  attention.  And  while  we  can- 
not expect  that  every  passing  headache  or  disagreeable  bodily 
sensation  will  be  allowed  to  drive  us  from  our  work;  it  is 
literally  true  that  many  serious  accidents,  grave  mistakes,  to- 
gether   with    other    business    muddles    and    industrial    blunders 


SUFFERIXG  AXD  PURPOSE  OF  PAIX  199 

would  be  avoided  if  men  and  women  when  suffering  serious  pain 
would  stop  work  long  enough  to  find  out  the  exact  cause  of  their 
pain,  and  put  forth  intelligent  efforts  to  bring  about  its  cure 
by  removing  the  cause. 

Even  in  large  factories  and  business  establishments,  it  would 
result  in  a  higher  type  of  work  and  save  much  money  in  the 
end,  if  every  employee  with  a  headache  or  other  serious  pain 
were  sent  home  each  morning  to  get  well.  Certainly  there  are 
times  and  emergencies  in  life  when  one  must  disregard  even 
the  red  danger  signal  of  pain  and  drive  on  bravely  and  fear- 
lessly regardless  of  the  consequences,  but  it  is  a  great  mistake 
thus  lightly  to  regard  the  warning  cries  of  pain  in  the  pres- 
ence of  the  ordinary  situations  of  life,  or  habitually  to  ignore 
the  admonition  of  suffering  until  it  is  too  late;  until  the  once 
easily  removed  and  quickly  curable  cause  of  the  pain  has  be- 
come established  as  an  incurable  disease  and  life  long  cause  of 
further  pain  and  increased  suffering,  or  results  in  a  bona  fide 
nervous  breakdown. 

SUMMARY    OF    THE    CHAPTER 

i.  Suffering  is  a  friendly  sentinel,  a  warning  messenger  and  a 
corrective  monitor.  Pain  is  the  outcry  of  the  physical  conscience 
against  nervous  abuses  and  disease  dangers. 

2.  Pain  commonly  results  from  inheriting  weak  nerves,  irri- 
tating the  brain  or  poisoning  the  nervous  system,  and  is 
indicative  of  wrong  habits,  disordered  nerves  or  unwholesome 
surroundings. 

3.  Pain  and  suffering  are  nothing  more  nor  less  than  trans- 
gression transposed  into  penalty. 

4.  The  voice  of  pain  is  reformatory  in  its  purpose,  while  the 
language  of  disease  is  corrective  in  its  mission;  hence  the  danger 
and  folly  of  pain-killers  and  patent  poisons. 

5.  When  long-standing  pain  must  be  relieved,  try  Nature's 
effective  remedies,  such  as  heat,  light,  rest,  massage,  and  an 
improved  mental  attitude. 

6.  The  purpose  of  affliction  is  to  produce  repentance  and 
reform,  hence  the  interval  between  seedtime  and  harvest  — 
Nature's  period  of  probation. 

7.  The  corrective  purpose  of  suffering  is  an  ancient  doctrine. 
Jeremiah  wrote:  "  Thine  own  wickedness  shall  correct  thee  and 
thine  backslidings  shall  reprove  thee." 

8.  Within  every  violation  or  compromise  of  the  laws  of  health 


200  WORRY  AND  NERVOUSXESS 

there  are  concealed  the  seeds  of  bodily  disease,  nervous  dis- 
order, and  physical  suffering. 

9.  It  is  literally  true  in  both  the  physical  and  mental  realms 
that  "  whatsoever  a  man  soweth,  that  shall  he  also  reap." 

10.  Genuine  pain  is  unvaryingly  the  effect  of  some  definite 
cause  —  physical  or  psychical.  It  is  the  handwriting  of  disease 
and  distress  on  the  walls  of  the  living  temple. 

11.  We  must  learn  how  to  translate  the  voice  of  pain  into 
terms  of  transgression  and  interpret  the  language  of  disease  into 
acts  of  reform. 

12.  Acute  diseases  are  ordinarily  corrective  and  curative; 
while  the  later  stages  of  chronic  disease  are  usually  degenerative 
and  destructive. 

13.  All  the  world  has  been  baptized  in  the  fellowship  of 
physical  suffering.  Love  and  sympathy  are  often  conceived  in 
pain  and  born  in  sorrow. 

14.  Pain  disciplines  the  wayward,  corrects  the  erring,  subdues 
the  proud,  warns  the  headstrong,  and  makes  wise  the  ignorant. 

15.  Nature  is  indiscriminating  in  her  penalties;  whether  the 
nights  are  spent  in  dissipation  or  at  the  bedside  of  the  sick,  the 
results  of  overexertion  are  just  the  same. 

16.  Pain  never  fails  to  harden  or  melt.  It  either  sweetens  or 
sours  the  disposition. 

17.  In  this  world  it  is  the  weak  as  well  as  the  wrong  who 
suffer.  The  child  born  a  neurological  bankrupt  is  doomed  by  his 
weakness  to  suffer  along  with  the  wicked. 

18.  Pain  and  pleasure  are  close  of  kin,  and  whether  a  given 
excitation  results  in  pain  or  pleasure  is  determined  by  the  mental 
state,  as  well  as  by  the  degree  of  stimulation. 

19.  Pain  is  a  danger  signal  —  an  automatic  and  ever  acting 
system  of  alarm  wires,  stretched  out  over  the  vast  physical 
domain. 

20.  Pain  and  suffering  constitute  the  physical  conscience  of 
the  body.  Pain  is  the  pathetic  prayer  of  the  nerve  for  rest, 
relief,  or  recreation. 

21.  Painful  sensations  are  Nature's  automatic  speed  regulator, 
and  while  it  may  be  temporarily  ignored,  it  demands  attention 
sooner  or  later. 


CHAPTER  XVI 
SPECIAL  FORMS  OF  NEURASTHENIA 

THE  reader's  attention  has  already  been  called  to  the  fact 
that  the  clinical  symptoms  of  neurasthenia  are  often 
largely  confined  to  a  single  organ  or  group  of  organs  thus 
giving  rise  to  the  so-called  local  or  specialized  forms  of  nervous 
exhaustion.  We  have  previously  classified  these  special  forms 
of  neurasthenia  under  five  heads ;  viz. :  cerebral,  spinal,  gastric, 
sexual,  and  traumatic. 

CEREBRAL    NEURASTHENIA 

This  is  the  form  of  nervous  disorder  in  which  the  symptoms 
are  practically  confined  to  the  head  — to  sensations  and  pains 
in  the  brain,  on  the  scalp  and  at  the  base  of  the  brain.  These 
patients  are  tortured  by  regular  and  characteristic  headaches 
and  all  the  other  cranial  pains  so  fully  noted  in  a  previous 
chapter.  They  frequently  entertain  grave  fears  of  losing  their 
minds.  Their  weakness  or  fatigue  is  more  intellectual  than 
physical,  and  the  whole  picture  of  the  disease,  including  its 
hereditary  background,  is  such  as  to  strongly  suggest  psychas- 
thenia.  It  is  my  opinion  that  further  knowledge  of  this  so-called 
cerebral  neurasthenia  will  lead  to  a  recognition  that  the  major- 
ity of  these  cases  are  in  reality  true  psychasthenias. 

SPINAL    NEURASTHENIA 

Now  we  come  to  the  nervous  patient  with  a  multitude  of 
backaches,  side  aches,  and  numerous  other  pains  including  more 
or  less  of  headache.  These  are  the  patients  who  have  been 
diagnosed  as  having  "irritable  spinal  columns,"  "nervous 
backs,"  and  "neurasthenic  spines."  They  frequently  suffer 
from  a  minimum  of  mental  or  physical  fatigue.  They  fre- 
quently  undergo   unnecessary   surgical   operations   and   submit 

201 


202  WORRY  AND  NERVOUSNESS 

to  course  after  course  of  futile  treatments  and  manipulations 
in  their  earnest  efforts  to  cure  their  "  miserable  backs."  The 
great  variety  of  symptoms  connected  with  this  particular  form 
of  the  disease  has  also  been  fully  noted. 

The  essential  point  in  the  treatment  of  spinal  neurasthenia  is 
to  promote  the  circulation  of  the  blood  throughout  the  spinal 
region  by  means  of  alternate  hot  and  cold  applications  in  con- 
junction with  massage.  In  many  of  these  cases,  the  spinal 
nerve  centers  are  literally  starved  from  lack  of  blood  which  has 
been  so  largely  diverted  into  the  dilated  vessels  and  over- 
distended  viscera  of  the  abdomen  and  pelvis.  In  these  cases, 
the  proper  treatment  and  cure  of  this  stagnant  circulation  of 
the  abdomen,  by  the  wearing  of  a  suitable  abdominal  support, 
and  other  methods,  will  be  found  a  great  help  in  bringing  about 
the  cure  of  these  spinal  neurasthenics. 

GASTRIC    NEURASTHENIA 

Now  we  come  to  a  highly  interesting  group  of  human  suf- 
ferers. The  term  dyspepsia  has  certainly  been  made  to  cover 
a  multitude  of  sufferings  on  the  part  of  the  patient  as  well  as 
a  vast  realm  of  indifference  and  ignorance  on  the  part  of  the 
physician.  It  used  to  be  the  custom  to  call  all  stomach  and  di- 
gestive troubles,  dyspepsia.  Nowadays  the  physician  recognizes 
that  when  there  is  pain  in  the  stomach  there  is  something  def- 
initely wrong  with  the  digestive  machinery,  and  a  painstaking 
examination  usually  discloses  the  presence  of  ulcers,  gallstones, 
or  a  chronic  appendicitis,  and  so  these  surgical  maladies  arc 
now  forever  removed  from  the  realms  of  so-called  dyspepsia. 

Having  removed  the  real  digestive  diseases  from  the  class- 
ification of  stomach  disorders,  about  all  we  have  left  to  sail 
under  the  flag  of  dyspepsia  is  "  nervous  indigestion,"  "  gastric 
neurasthenia,"  with  its  associated  chronic  constipation  and  its 
consequental  general  autointoxication.  In  my  practice,  the 
diagnosis  of  indigestion  and  dyspepsia  is  practically  limited  to 
these  nervous  disturbances  of  the  stomach  and  intestines,  where 
no  real  lesion  can  be  detected  and  which  almost  invariably  are 
to  be  found  in  those  patients  who  present  the  unmistakable 
clinical  picture  of  gastric  neurasthenia. 


SPECIAL  FORMS  OF  NEURASTHENIA  203 

The  treatment  of  the  gastric  neurasthene  is  largely  psycho- 
therapeutic. Efforts  must  be  made  to  improve  the  general  cir- 
culation and  increase  the  nerve  tonus.  A  liberal,  fairly  easy 
digested  diet  must  be  prescribed.  It  is  imperative  that  the 
accompanying  constipation  be  relieved  —  this  is  the  most  im- 
portant part  of  the  physical  treatment.  The  real  cure  consists 
in  the  elimination  of  the  patient's  psychic  dyspepsia  and  this  is 
accomplished  by  wise  and  persistent  mental  training  carried 
forward  to  that  point  where  the  patient  is  able  fully  to  recog- 
nize the  psychic  basis  and  nervous  origin  of  his  manifold  and 
distressing  symptoms. 

SEXUAL   NEURASTHENIA 

We  are  constantly  meeting  with  cases  of  neurasthenia  in 
which  the  larger  part  of  both  mental  and  the  physical  symp- 
toms and  complaints  are  referable  to  the  generative  mechanism 
and  the  sex  life  of  the  individual,  and,  following  the  rule  es- 
tablished in  our  clinical  classification  of  these  nervous  dis- 
orders, we  naturally  call  this  group  of  morbid  sufferers  by  a 
term  indicative  of  the  chief  symptoms  of  which  they  complain. 

First  and  foremost  among  the  sex  neurasthenes  our  atten- 
tion and  sympathy  is  directed  to  that  pathetic  group  of  suf- 
ferers from  so-called  female  weaknesses  —  those  dejected 
victims  of  female  complaints  —  and  to  that  equally  pitiable 
group  of  young  men,  or  even  middle  aged  men,  who  have  been 
foolishly  led  into  the  erroneous  belief  that  some  small  per- 
version of  a  physiological  function  in  youth  can  continue  to 
cause  serious  symptoms  ten  or  twenty  years  later.  This  group 
of  patients  have  long  been  a  rich  field  of  exploitation  on  the 
part  of  both  the  quack  doctor  and  the  patent  medicine  vender. 

When  anything  is  actually  wrong  with  the  human  generative 
system,  it  certainly  needs  to  be  attended  to;  but  in  sex  neuras- 
thenia there  is  a  well-defined  tendency  to  seize  upon  the  slight- 
est pretense  —  the  most  trifling  displacement  or  the  slightest 
symptom  —  and  then  to  make  a  pathological  mountain  out  of 
this  insignificant  mole  hill  of  disease.  There  is  certainly  no 
form  of  neurasthenia  in  which  the  patient  can  be  so  literally 
"  scared  to  death,"  as  the  form  under  present  discussion. 


204  WORRY  AND  NERVOUSNESS 

Just  as  the  gastric  neurasthene  is  always  complaining  of  a 
dilated  or  prolapsed  stomach,  the  sexual  neurasthene  has  the 
mind  ever  focused  on  the  reproductive  organs,  always  alarmed 
at  some  new  appearing  symptom  or  the  aggravation  of  some 
old  complaint. 

In  the  case  of  the  woman,  the  origin  of  this  difficulty  may 
be  accounted  for  by  the  increased  impressionability  associated 
with  the  physical  and  nervous  disturbances  which  almost  un- 
failingly accompany  menstruation.  As  in  other  forms  of  the 
disease  the  neurasthenic  mind  seizes  upon  that  which  is  per- 
fectly normal  and  wholly  physiological  and  successfully  twists 
and  perverts  it  into  a  health  destroying  worry. 

INFLUENCE  OF   ADOLESCENCE. 

The  period  of  puberty  ushers  in  a  marked  change  of  mental- 
ity, more  especially  on  the  part  of  boys,  and  as  a  result  of 
the  gross  ignorance  which  is  so  often  allowed  to  prevail,  cer- 
tain physical  practices  and  mental  habits  may  be  set  in  opera- 
tion at  this  time  which  will  effectually  undermine  the  nervous 
vitality  and  so  distort  the  mental  viewpoint  of  life,  as  effectu- 
ally to  lay  the  foundation  for  a  slowly  developing  case  of  sex- 
ual neurasthenia. 

It  is  the  belief  of  many  eminent  neurologists  that  early  sex 
experiences,  disturbances  of  the  affection,  the  arousal  of  emo- 
tional fears,  and  numerous  social  shocks  (many  or  all  of  which 
may  be  successfully  suppressed)  are  able  so  to  permeate  the 
consciousness  of  later  years  —  to  envelop  the  mind  —  to  obtain 
such  a  morbid  domination  over  the  intellect,  as  to  result  in 
the  subsequent  production  of  a  well  marked  and  obstinate 
case  of  sexual  neurasthenia. 

It  is  a  blot  upon  the  fair  name  of  our  Christian  civilization 
that  our  laws  and  legal  regulations  have  been  so  lax  as  to 
permit  the  medical  fakers  to  prey  unhindered  upon  the  sex 
fears  and  social  ignorance  of  the  youthful  neurasthene.  Many 
a  wrecked  career  —  yes,  even  cases  of  suicide  and  insanity  — 
are  directly  traceable  to  the  depressing  and  demoralizing  influ- 
ence of  these  quacks,  with  their  alarming  literature  and  their 
suggestive  newspaper  advertisements. 


SPECIAL  FORMS  OF  NEURASTHENIA  205 

While  this  is  not  the  proper  place  to  enter  into  a  full  dis- 
cussion of  the  sex  hygiene  of  the  adolescent  youth,  it  must  be 
recognized  that  such  instruction  given  in  a  sane  and  sensible 
manner  at  the  proper  time  and  by  the  proper  persons,  is 
indispensable  to  the  prevention  of  a  further  increase  in  that 
downcast  and  dejected  army  of  sexual  neurasthenics. 

I  have  seen  many  of  these  cases  both  of  young  men  and 
young  women  who  had  worried  themselves  almost  to  death. 
They  had  despaired  of  marriage  and  looked  forward  to  either 
a  life-long  invalidism  or  to  an  unhappy  sojourn  behind  asylum 
bars;  all  because  of  some  trifling  youthful  indiscretion  or  be- 
cause of  some  wholly  natural  and  normal  sex  phenomenon, 
which,  because  of  their  dense  ignorance,  had  aroused  a  host 
of  alarming  fears  in  their  minds,  leading  them  to  believe  they 
were  victims  of  some  insidious,  devitalizing  disease,  when,  in 
reality,  their  experience  was  wholly  natural  and  normal ;  not 
different  at  all  from  that  of  all  their  ancestors  before  them, 
and  not  at  all  unlike  that  of  the  average  man  or  woman  of 
the  present. 

What  a  crime  against  young  manhood  and  womanhood  to 
permit  the  tragic  hour  of  the  unfolding  of  the  sex  mysteries 
to  overtake  and  find  their  minds  in  a  state  of  unenlightened 
fear !  What  a  travesty  on  modern  education  that  the  physio- 
logical phenomenon  invariably  associated  with  the  bud  of  early 
manhood  and  the  bloom  of  approaching  womanhood  should  be 
allowed  to  overtake  and  find  the  adolescent  youth  in  such  a 
state  of  abject  biological  ignorance  that  the  entire  intellect 
and  nervous  system  is  so  shocked  and  demoralized  —  the  nerv- 
ous equilibrium  so  disturbed  —  that  the  foundations  are  thus 
early  laid  for  the  later  appearance  and  development  of  a  well 
defined   sexual  neurasthenia  ! 

SOCIAL    TRANSGRESSION 

I  am  well  aware  that  not  all  of  the  sexual  neurasthenia  of 
the  present  generation  has  its  origin  in  the  failure  to  teach  sex 
hygiene  to  the  adolescent  youth.  Xo  practicing  physician  can 
remain  blind  to  the  fact  that  intemperance  and  prostitution,  with 
their  resultant  venereal  miseries  and  diseases,  are  directly  and 


206  WORRY  AXD  NERVOUSNESS 

indirectly  responsible  for  many  a  case  of  so-called  sex  neuras- 
thenia. The  medical  man  is  fully  aware  that  the  long  con- 
tinued abuse,  misuse,  and  over  excitation  of  such  a  highly 
organized  and  delicately  adjusted  mechanism  as  that  of  the 
human  reproductive  system,  cannot  fail  —  at  least  in  the  cases 
of  certain  nervously  predisposed  individuals  —  to  bring  on  the 
symptoms  of  a  sexual  neurasthenia,  or  to  precipitate  some  sort 
of  a  neurological  catastrophe. 

Many  instances  of  this  unfortunate  nervous  malady  are  also 
brought  to  the  surface  by  certain  incompatibilities  of  mar- 
ried life.  These  difficulties  are  sometimes  very  distressing  to 
the  parties  themselves,  and  highly  perplexing  to  the  physician 
in  his  efforts  to  give  the  advice  which  will  prove  best  for  all 
concerned. 

Another  result  of  this  sex  ignorance  and  social  prudery  is 
the  production  of  those  unfortunate  individuals  with  homo- 
sexual tendencies.  They  exist  in  far  greater  numbers  than  is 
commonly  suspected.  Cases  of  this  sort  are  constantly  com- 
ing to  the  notice  of  the  physician  who  sees  a  large  number  of 
"  nervous  "  patients. 

DEMENTIA   PRAEC0X 

The  milder  and  more  common  forms  of  sexual  neurasthenia 
which  are  so  largely  amenable  to  treatment,  must  not  be  con- 
founded or  confused  with  that  more  serious  and  grave  mental 
disorder  known  as  dementia  praecox  which  also  seems  to  owe 
its  origin  and  existence  to  some  sort  of  derangement  or  per- 
version of  the  secretory  workings  of  the  sex  glands. 

Dementia  praecox  is  in  reality  a  form  of  insanity.  It  usu- 
ally appears  early  in  life  and  is  characterized  by  a  peculiar 
enfeeblement  of  mind,  emotional  indifference,  weakness  of 
judgment,  flightiness,  automatic  obedience,  impulsive  actions, 
affectations,  unemotional  laughter,  hallucinations,  and  sometimes 
delusions  of  either  a  depressed  or  grandiose  nature. 

About  fifteen  per  cent  of  all  the  insane  patients  admitted  to 
our  asylums  belong  to  this  group,  and  in  the  vast  majority 
of  cases  the  disease  makes  its  appearance  before  the  twenty- 
fifth  year.     The  two  sexes  are  about  equally  liable  to  the  dis- 


SPECIAL  FORMS  OF  XEURASTHEXIA  207 

order  and  heredity  is  noted  in  seventy  per  cent.  Physical  stig- 
mata of  degeneration  are  also  frequently  observed.  The  dis- 
order not  infrequently  makes  its  appearance  following  some 
severe  acute  disease  such  as  typhoid  or  scarlet  fever.  The 
prognosis  is  unfavorable,  most  cases  ending  in  permanent  de- 
mentia, but  a  few  do  recover. 

TREATMENT    OF    SEX    NEURASTHENIA 

While  the  general  treatment  of  neurasthenia  will  be  dis- 
cussed in  later  chapters,  it  will  be  in  order  to  give  some  spe- 
cial instruction  at  this  time  regarding  the  management  of  the 
particular   form  of  nervous  disorder  under  consideration. 

The  alternate  hot  and  cold  sitz  bath,  alternate  hot  fomenta- 
tions and  ice  rubs  to  the  spine,  together  with  other  general 
hydriatic  tonic  procedures,  electricity  and  massage,  are  all 
of  more  or  less  help  in  the  successful  treatment  of  sexual 
neurasthenia.  But  the  most  important  of  all  remedial  meas- 
ures is  the  proper  and  persistent  employment  of  such  psycho- 
therapeutic methods  as  will  enlighten  and  strengthen  the 
patient's  mind,  and  otherwise  so  change  his  viewpoint  as  effectu- 
ally to  destroy  the  dominance  and  tyranny  of  his  distorted  sex 
thoughts  and  perverted  sex  feelings. 

I  find  it  necessary  to  sit  down  with  these  patients  by  the 
hour  and  in  a  simple  and  painstaking  manner  teach  them,  un- 
fold to  them,  the  simple,  beautiful  and  fascinating  biological 
truths  associated  with  the  science  of  reproduction.  These 
patients  all  stand  in  need  of  being  instructed  in  the  anatomy, 
physiology,  hygiene,  and  significance  of  the  reproductive  mech- 
anism and  functions.  It  is  absolutely  necessary  to  destroy  igno- 
rance and  banish  fear  if  we  hope  to  contribute-  anything  to  the 
liberation  of  the  minds  and  the  upbuilding  of  the  bodies  of  these 
unfortunate  sufferers. 

TRAUMATIC    NEURASTHENIA 

This  is  the  form  of  nervous  prostration  which  results  from 
railway  accidents,  automobile  smash-ups  and  other  tragic  acci- 
dents. This  form  of  nervous  disorder  may  also  be  precipi- 
tated by  sudden  and  violent  trauma,  such  as  sudden  death  in 


208  1V0RRY  AXD  NERVOUSNESS 

the  family,  business  reverses,  divorces,  and  other  experiences 
associated  with  keen  regret,  profound  worry,  and  unusual 
anxiety. 

The  treatment  in  general  of  this  as  well  as  of  the  other 
specialized  forms  of  neurasthenia  noted  in  this  chapter  will 
be  duly  considered  in  later  chapters. 

SUMMARY    OF    THE    CHAPTER 

1.  The  special  clinical  forms  of  neurasthenia  are  cerebral, 
spinal,  gastric,  sexual  and  traumatic. 

2.  In  cerebral  neurasthenia  the  symptoms  are  largely  confined 
to  characteristic  headaches  and  other  cranial  symptoms. 

3.  In  spinal  neurasthenia  the  patient's  complaints  are  largely 
limited  to  the  spinal  column  —  tenderness,  backache,  side- 
aches,  etc. 

4.  Gastric  neurasthenia  is  nervous  dyspepsia,  and  is  usually 
associated  with  chronic  constipation  and  autointoxication. 

5.  Chronic  dyspepsia  is  usually  the  result  of  ulcers,  gallstones, 
or  appendicitis  on  the  one  hand;  or  of  nervous  indigestion  — 
gastric  neurasthenia  —  on  the  other  hand. 

6.  The  cure  of  gastric  neurasthenia  lies  in  the  physical  treat- 
ment of  constipation  and  the  mental  cure  of  psychic  dyspepsia. 

7.  In  nervous  exhaustion  when  the  chief  symptoms  and  com- 
plaints are  referable  to  the  reproductive  system,  the  disorder  is 
called  sexual  neurasthenia. 

8.  Those  patients  who  chronically  suffer  from  "  female  com- 
plaints," are  usually  sexual  neurasthenics.  They  are  good 
patrons  of  both  the  quack  and  the  patent  medicine  vender. 

9.  Another  form  of  this  disorder  is  the  youth  or  man  of  middle 
age  who  morbidly  fears  that  his  life  has  been  ruined  by  some 
youthful  physiological  error. 

10.  Much  of  this  disorder  is  due  to  the  gross  ignorance  regard- 
ing those  natural  phenomena  associated  with  the  reproductive 
organs  and  which  make  their  appearance  at  puberty. 

11.  Failure  to  teach  sex  hygiene  at  the  right  time  and  in  the 
right  way,  as  well  as  hereditary  predisposition,  is  largely  respon- 
sible for  many  cases  of  sexual  neurasthenia. 

12.  It  is  a  travesty  on  Christian  civilization  that,  through 
ignorance  and  fear,  Nature's  adolescent  developments,  menstrua- 
tion, etc.,  should  result  in  such  shocks  as  to  upset  the  nervous 
system. 

13.  Sex  neurasthenia  is  also  produced  by  intemperance,  and 
prostitution  with  its  venereal  miseries  and  diseases. 

14.  Abnormality,   perversions,  and   suppression  of  sex   func- 


SPECIAL  FORMS  OF  NEURASTHENIA  209 

tions  are  responsible   for  a  large  amount  of  nervousness  and 
other  troubles  both  inside  and  outside  of  wedlock. 

15.  Dementia  Praecox  is  a  form  of  insanity  supposed  to  have 
its  origin  in  some  perversion  of  the  sex  secretions. 

16.  The  special  treatment  of  sex  neurasthenia  consists  in  the 
application  of  suitable  physical  measures  in  conjunction  with 
persistent  educational  psychotherapy. 

17.  Traumatic  neurasthenia  is  that  form  of  nervousness  which 
is  precipitated  by  railroad  accidents,  automobile  smash-tips  and 
sudden  business  reverses,  death,  etc. 


CHAPTER  XVII 
PSYCHASTHEXIA  OR  TRUE  BRAIX  FAG 

WE  NOW  come  to  the  study  of  one  of  the  more  newly 
classified  nervous  disorders  —  psychasthenia.  While  all 
psychasthenes  are  more  or  less  neurasthenic,  and  many  neuras- 
thenes  are  more  or  less  psychasthenic,  nevertheless,  as  we  have 
previously  noted,  there  is  a  decided  clinical  difference  between 
these  two  nervous  conditions. 


Many  unfortunate  individuals  are  condemned  to  go  through 
life  with  a  functionally  crippled  nervous  system.  They  are 
fore-doomed  to  suffer  more  or  less  from  mental  fatigue  — 
brain  f ag  —  all  of  which  is  due  to  the  laws  of  human  inheri- 
tance; it  is  nothing  more  or  less  than  a  case  of  the  father's 
eating  sour  grapes  and  the  children's  teeth  being  set  on  edge. 

The  psychasthene  is  able  often  to  comfort  himself  with  the 
flattering  knowledge  that  he  travels  in  exceedingly  good  com- 
pany, for  it  is  a  fact  that  a  very  large  number  of  the  world's 
geniuses  in  science,  art,  and  letters,  have  been  more  or  less 
psvehasthenic.  Many  individuals  who  manifest  exceptional 
control  of  the  mind  along  some  particular  line,  are  found  to  be 
greatly  lacking  in  brain  control  as  regards  the  common  experi- 
ences of  their  everyday  life. 

I  do  not  for  one  moment  admit  that  psychasthenia  is  the 
gigantic  disorder  which  its  discoverer,  Janet,  claims  it  to  be. 
This  French  authority  would  lead  us  to  believe  that  psychasthe- 
nia embraces  almost  every  sort  of  nervous  disturbance  ranging 
from  simple  neurasthenia  up  to  melancholia  and  arrant  mad- 
ness. I  look  upon  psychasthenia  as  an  hereditary  affair  —  as 
an  hereditary  weakness  in  the  matter  of  brain  control  and  emo- 
tional  reaction.      Of   course,   I   also   recognize   that   overwork, 

210 


PSYCHASTHEXIA  OR  TRUE  BRAIN  FAG        211 

emotional  stress,  and  intoxication,  together  with  all  of  the  so- 
called  neurasthenic  factors,  may  serve  to  develop  and  accentu- 
ate this  hereditary  psychasthenic  predisposition. 

Many  a  psychasthenia  does  not  appear  in  the  individual's 
experience  until  the  nervous  system  is  subjected  to  some  extra- 
ordinary strain.     On  this  point,   Dubois  remarks: 

Unquestionably  we  often  see  sick  people  who  tell  us  that  they  once 
enjoyed  good  health,  and  trace  the  beginning  of  their  illness  back  to 
a  certain  date.  But  if  we  take  the  trouble,  by  lengthy  and  frequent 
conversations,  to  scrutinize  the  mental  past  of  these  patients,  and  to 
analyze  their  previous  state  of  mind,  we  find  no  difficulty  in  recog- 
nizing that,  long  before  the  development  of  the  actual  trouble,  the 
mental  stigmata  of  neuroses  were  traceable,  and  the  event  that 
brought  on  the  acute  symptoms  was  only  the  drop  of  water  that  made 
the  vessel  overflow. 

THE   EMOTIONAL  THRESHOLD 

Psychasthenia  is,  in  reality,  a  lowering  of  the  emotional 
threshold.  It  differs  from  ordinary  neurasthenia  not  only  in 
the  fact  of  its  more  uniform  hereditary  origin,  but  also  in 
the  fact  that  it  is  more  largely  concerned  with  purely  psychic 
and  emotional  influences  as  regards  its  exciting  causes.  A 
recent  writer,  in  emphasizing  this  distinction  has  well  said: 

In  ordinary  neurasthenia  the  exciting  causes  are  the  exceedingly 
frequent  occasions  of  grief,  fear,  and  anger,  which  are  perfectly  real 
but  so  slight  that  only  the  abnormally  sensitive  brain  is  harmfully 
affected  by  them.  In  psychasthenia  the  exciting  cause  of  disturbance 
is  merely  the  mental  representation  of  a  cause  for  emotion  which  for 
the  patient  does  not  exist  at  all,  but  which  would  be  amply  sufficient 
to  affect  a  normal  brain  if  it  did  exist. 

Thus  a  psychasthenic  girl  passing  a  house  sees  some  glasses  of 
jelly  exposed  on  a  window  sill.  The  thought  comes,  "Some  one 
might  put  poison  into  that  jelly;  what  if  I  should  do  it?  "  The  mere 
thought  provokes  such  a  feeling  of  horror  that  she  goes  home  crying. 
A  few  weeks  later,  she  takes  part  in  a  cooking-school  exercise  and  :3 
vividly  reminded  of  the  ideas  concerning  the  jelly,  but  keeps  control 
until  one  of  the  children  who  has  eaten  what  she  helped  to  prepare 
begins  to  complain  of  illness.  Then  the  mere  idea,  which  she  knows 
to  be  utterly  false,  of  having  put  poison  into  the  food    provokes  a 


212  WORRY  AND  NERVOUSNESS 

violent  outburst  of  grief.  All  normal  persons  have  some  emotional 
reaction  to  mental  representations  which  they  know  to  be  purely 
imaginary,  as  in  reading  fiction  or  seeing  a  play.  The  theatregoer, 
the  novel  reader,  the  daydreamer,  may  really  tremble,  shed  real  tears, 
or  contract  his  muscles  in  righteous  anger,  but  he  restrains  himself 
and  quickly  recovers  emotional  equilibrium.  Not  so  the  psychasthene. 
His  emotional  centers  are  so  oversensitive  that  a  purely  accidental 
image  of  himself  as  suffering  a  violent  death,  committing  a  dreadful 
crime  or  being  insane  arouses  an  intense  horror.  The  intensity  of  the 
experience  fixes  it  in  memory;  it  becomes  associated  with  almost 
everything,  and  the  harmful  emotion  becomes  habitual.  The  impor- 
tant fact  in  such  a  case  is  not  the  nature  of  the  idea,  or  how  it  came 
into  consciousness  or  whether  or  not  it  has  been  repressed  into  the 
cellar  of  subconsciousness;  these  may  have  some  importance;  but  the 
great  fact  is  the  physical  condition  of  the  cortex  which  permits  such 
excessive  and  uncontrolled  reactions. 

In  many  respects  the  psychasthenes  behave  and  reason  much 
like  a  child.  They  are  affected  by  external  influences  and  react 
to  internal  impulses  in  a  manner  which  indicates  that  their 
viewpoint  is  that  of  the  easily  upset  and  quickly  alarmed 
mentality  of  the  child  mind. 

NEURASTHENIA   AND  PSYCHASTHENIC 

To  still  further  make  clear  the  difference  between  neuras- 
thenia and  psychasthenia,  I  may  say  that  those  influences  of 
irritation,  stress,  and  strain,  which  would,  in  a  fairly  normal 
individual,  result  in  producing  a  case  of  true  neurasthenia, 
will,  in  the  case  of  these  susceptible  and  hereditarily  predis- 
posed individuals,  produce  a  genuine  case  of  psychasthenia. 
The  perplexing  feature  of  such  cases  of  so-called  acquired 
psychasthenia  (in  reality,  hereditary)  is  that  in  the  earlier 
stages  they  are  accompanied  by  nearly  all  of  the  commonly  ob- 
served symptoms  which  belong  to  neurasthenia.  On  the  other 
hand,  psychasthenics  are  far  more  likely  to  manifest  symptoms 
which  are  suggestive  of  more  serious  mental  disorders  than 
neurasthenia;  and,  therefore,  as  a  clinical  disorder,  psychas- 
thenia comes  thus  to  occupy  a  place  between  the  less  serious 
neurasthenias  on  the  one  hand  and  the  more  serious  hysterias, 
phobias,  melancholias,  and  manias  on  the  other  hand. 


PSYCHASTHEXIA  OR  TRUE  BRAIX  FAG        213 

ACTIVE  AND  LATENT   FORMS 

The  so-called  congenital  psychasthenia  usually  makes  its 
appearance  at  or  around  puberty.  The  child  is  spoken  of  as 
delicate,  nervous  and  timid;  while  the  acquired  form  (I  prefer 
the  term  latent)  may  not  appear  until  the  patient  is  well  passed 
middle  life,  and  then  only  after  some  prolonged  and  unusual 
period  of  hard  work  and  over-worry.  Many  a  business  or 
professional  man  experiences  his  first  real  attack  of  neuras- 
thenia or  psychasthenia  when  between  forty  and  fifty  years  of 
age.  Others  are  able  to  postpone  this  catastrophe  until  after 
retiring  from  business  and  then,  with  nothing  to  think  about 
but  themselves,  they  quickly  succumb  to  their  latent,  hereditary 
nervous  tendencies,  and  with  amazing  rapidity  develop  into 
full  fledged  neurasthenes  or  psychasthenes. 

At  the  present  time  I  have  a  patient  fifty-five  years  of  age 
who  has  until  recently  been  at  the  head  of  a  large  business 
enterprise.  Xow  he  has  retired,  and  although  for  twenty-five 
years  he  was  threatened  off  and  on  with  nervous  breakdown 
which  he  always  successfully  avoided,  now  he  is  the  victim 
of  a  most  distressing  psychasthenia.  His  mental  fatigue  terribly 
annoys  him,  his  appetite  is  gone,  his  sleep  disturbed,  his  initiative 
is  slipping,  and  it  is  little  wonder  that  he  complains  that  his 
mental  powers  are  "breaking  up,"  and  that  he  gravely  fears 
insanity.  And  yet  his  ailment  is  nothing  more  than  this 
acquired    (latent)    form  of  psychasthenia. 

EMINENT  PSYCHASTHENES 

The  thought  must  not  for  one  moment  be  entertained  that 
our  psychasthenes  are  recruited  from  the  ranks  of  hysterics, 
and  other  people  of  mediocre  mental  caliber.  As  previously 
remarked,  they  are  frequently  found  among  the  most  intellec- 
tual classes;  and  many  of  these  great  minds  have  been  so  suc- 
cessful in  the  mastery  of  their  mental  and  nervous  weaknesses 
that  they  have  been  able  entirely  to  surmount  their  hereditary 
tendencies  and  otherwise  to  overcome  and  repair  their  loss  of 
nerve  control. 

Sir  Francis  Galton,  the  eminent  British  scientist  —  the  father 
of  our  infant  science  of  eugenics  —  and  who  lived  well  beyond 


214  WORRY  AND  NERVOUSNESS 

four  score  years  in  the  full  possession  of  his  mental  and  physical 
powers,  meanwhile  turning  out  a  vast  volume  of  work,  was 
evidently  predisposed  to  psychasthenia,  for,  concerning  one  of 
his  attacks  or  breakdowns,  he  says: 

I  suffered  from  intermittent  pulse  and  a  variety  of  brain  symptoms 
of  an  alarming  kind.  A  mill  seemed  to  be  working  inside  my  head; 
I  could  not  banish  obsessing  ideas ;  at  times  I  could  hardly  read  a 
book,  and  found  it  painful  to  look  at  even  a  printed  page.  Fortu- 
nately I  did  not  suffer  from  sleeplessness,  and  my  digestion  failed 
but  little.  Even  a  brief  interval  of  rest  did  me  good,  and  it  seemed 
as  if  a  dose  of  it  might  wholly  restore  me.  It  would  have  been  mad- 
ness to  continue  the  kind  of  studious  life  that  I  had  been  leading.  I 
had  been  much  too  zealous,  had  worked  too  irregularly  and  in  too 
many  directions,  and  had  done  myself  serious  harm. 

AN    ANCESTRAL   LEGACY 

Psychasthenes  are  like  poets  —  born,  not  made.  Neverthe- 
less, it  must  not  be  supposed  that  every  one  who  is  afflicted  with 
worry,  fears,  and  obsessions,  is  a  victim  of  psychasthenia.  On 
the  other  hand,  when  not  one  but  all  of  these  imperative  moods 
of  thought  coupled  with  enfeebled  will  power  and  accompanied 
by  more  or  less  brain  fag  —  I  say,  when  all  this  infernal  group 
— manifest  themselves  comparatively  early  in  life,  without  ade- 
quate cause,  and  are  sufficiently  developed  as  seriously  to  inter- 
fere with  and  lessen  one's  usefulness,  then  I  think  it  is  safe 
to  diagnose  such  a  condition  of  affairs  as  psychasthenia. 

And  so  psychasthenia  must  be  looked  upon  more  or  less  as 
a  part  of  one's  ancestry.  It  is  some  sort  of  defect  in  hereditary 
evolution,  and,  therefore,  overtakes  us  without  our  will  or  leave. 
Our  personal  responsibility  is  only  concerned  in  and  by  those 
methods  and  measures  which  on  the  one  hand  tend  to  make 
the  situation  worse,  and  on  the  other,  to  assist  in  overcoming 
nature's  handicap,  thus  enabling  the  patient  to  make  a  creditable 
showing  with  an  otherwise  abnormal  nervous  mechanism  and 
a  crippled  nervous  control. 

PSYCHASTHENIC    FATIGUE 

The  psychasthene  is  the  individual  who  was  "born  tired," 
and  who  has  remained  more  or  less  tired  throughout  life.     A 


PSYCHASTHENIA  OR  TRUE  BRAIN  FAG        215 

careful  medical  examination  will  differentiate  between  the 
"  weariness  "  of  psychic  fatigue  and  numerous  other  physical 
and  parasitic  maladies,  such  as  hook-worm  disease,  etc. 

Many  psychasthenes  who  are  born  and  reared  in  the  country 
get  along  fairly  well.  Those  who  are  unfortunate  enough  to 
grow  up  in  a  great  city  find  it  much  more  difficult  to  live 
happy,  useful,  and  self-supporting  lives.  It  is  largely  from 
this  class  of  neurologically  disinherited  individuals,  that  the 
common  "  ne'er-do-wells  "  of  modern  society  are  recruited.  The 
majority  of  our  inveterate  and  incurable  tramps  are  affected 
with  this  psychasthenic  taint ;  as  are  also  those  scions  of  certain 
aristocratic  and  wealthy  families  who  are  now  and  then  so 
strikingly  attacked  with  the  wanderlust.  It  would  thus 
appear  that  the  term  "  psychasthenia  ?'  might  be  pressed  into 
service  for  the  purpose  of  describing  certain  strata  of  modern 
society  which  are  otherwise  commonly  and  vulgarly  called 
"  lazy." 

It  is  the  handicapped  individual  suffering  from  an  extreme 
case  of  congenital  psychasthenia,  who,  when  he  finds  himself 
unable  to  compete  for  a  livelihood  with  his  fellows,  does  not 
hesitate  to  turn  criminal  and  begin  to  pillage  and  plunder  so- 
ciety. These  represent  the  brightest,  keenest,  and  the  shrewdest 
of  our  criminal  classes,  and  are  in  marked  and  striking  con- 
trast with  the  feeble-minded  criminals  who  compose  by  far  the 
larger  part  of  the  inmates  of  our  penal  institutions. 

PSYCHASTHENIC   SYMPTOMS 

In  addition  to  the  characteristic  mental  fatigue  of  psychas- 
thenia, the  patient  suffers  from  a  variety  of  mental  disturbances, 
many  of  which  are  identical  with  and  common  to  the  sufferings 
of  the  neurasthenic.  Practically,  the  chief  complaint  is  an 
incapacity  for  doing  things,  coupled  with  an  ever  present  over- 
attention  to  everything  connected  with  one's  thinking,  living, 
and  working. 

The  psychasthene  spends  the  larger  part  of  his  mental  effort 
and  nervous  energy  in  watching  himself  and  otherwise  trying 
to  help  carry  on  those  varied  mental  and  physical  processes 
which  nature  designed  to  be  automatically  executed.     In  this 


2x6  WORRY  'AND  NERVOUSNESS 

way  his  energies  are  almost  wholly  consumed  in  useless  chan- 
nels —  in  efforts  which  are  not  only  unnecessary,  but  which 
are  highly  harmful  to  the  healthy  and  normal  workings  of  both 
the  psychological  and  physiological  processes  and  mechanisms 
of  the  human  organism.  It  is  no  wonder  that  they  tire  so 
easily  when  we  pause  to  consider  the  vast  amount  of  useless 
effort  put  forth  by  these  meddlesome  methods  of  interference 
with  nature's  automatic  routine. 

PSYCHASTHENIC    INTROSPECTION 

All  introspective  patients  are  not  necessarily  psychasthenic, 
but  all  psychasthenes  are  introspective.  They  watch  all  the 
workings  of  the  mental  machinery  and  the  physical  processes 
with  the  eagle  eye  of  a  trained  detective.  They  are  incessantly 
spying  upon  themselves.  They  watch  the  minutest  details  of 
their  daily  work,  only  to  criticise  their  best  efforts  and  worry 
over  the  results.  When  they  engage  in  play  or  indulge  in 
recreation,  they  watch  so  closely  for  the  expected  rest  and 
relief,  that  they  effectually  spoil  and  destroy  all  the  good  that 
might  possibly  have  come  from  their  otherwise  beneficial  diver- 
sions. They  watch  their  stomachs  so  closely  as  to  lose  their 
appetite  and  spoil  their  digestion.  It  is  a  physiological  fact 
that  no  half-way  normal  self-respecting  stomach  will  continue 
to  do  a  good  grade  of  work,  if  its  owner  insists  on  constantly 
watching  its  operations  with  a  suspicious  eye. 

These  patients  even  try  to  watch  themselves  sleep,  and  of 
course,  there  can  be  but  one  result — insomnia.  And  even  when 
the  attention  is  relaxed  sufficiently  to  permit  sleep  to  overtake 
them,  their  slumbers  are  more  or  less  disturbed  by  nightmares 
and  other  vivid  dreams,  all  of  which  are  largely  born  of  the 
over-anxious  and  apprehensive  watchfulness  during  their  wak- 
ing hours.  And  so  it  is  little  wonder  that  they  waken  in 
the  morning  unrested  and  unrefreshed. 

OTHER  PSYCHASTHENIC  EAR-MARKS 

The  psychasthene  is  especially  prone  to  worry  about  his  work. 
He  is  always  going  back  to  see  if  things  are  done  right; 
trying  the  door   again  to   see   if   it  is  locked;  getting  up  out 


PSYCHASTHEXIA  OR  TRUE  BRAIX  FAG        217 

of  bed  and  going  down  stairs  to  see  if  the  cat  was  put  out  or 
the  dog  was  let  in.  A  sort  of  generalized  dread  seems  to 
possess  the  mind  —  a  sort  of  chronic  over-attention  to  things 
that  need  no  attention  —  a  sort  of  short-circuiting  of  the  nerv- 
ous forces  to  the  performance  of  useless  work,  as  in  the  case 
of  the  dynamo,  when  a  short  circuit  so  diverts  the  current  that 
instead  of  passing  outside  for  the  performance  of  useful  work, 
it  is  dissipated  within  the  generator,  thus  deranging  the  func- 
tions of  the  machine  and  interfering  with  both  the  quantity  and 
quality  of  its  work. 

Psychasthenics  frequently  appear  to  be  well  nourished  — in 
good  flesh.  It  is  such  cases  that  are  mistakenly  diagnosed 
neurasthenia,  and  are  started  out  on  long  walks,  horseback 
riding,  playing  golf,  etc.  Such  mistaken  treatment  only  leads 
to  early  and  utter  collapse  —  to  the  complete  discouragement 
of  the  patient  and  to  the  utter  bewilderment  of  friends  and 
family.  These  patients  are  not  like  the  mild  neurasthene  who 
is  fatigued  all  day  but  who  can  dance  all  night. 

The  psychasthene  is  usually  highly  impressionable,  more  or 
less  timid,  hesitating,  lacking  in  initiative,  an  odd  genius,  usually 
a  dreamer,  often  over-scrupulous,  unfailingly  exaggerating  the 
importance  of  his  personal  shortcomings,  all  the  while  ex- 
tremely irritable,  very  changeable  in  humor  and  more  or  less 
despondent  —  in  rare  cases  and  at  times,  even  mildly  melan- 
cholic. 

HISTORY  OF  A  PSYCHASTHENE 

Perhaps  I  cannot  do  better  in  summing  up  the  symptoms  of 
psychasthenia  than  to  give  the  history,  the  story  of  a  judge, 
forty-three  years  of  age,  as  recited  by  himself: 

I  have  always  had  a  delicate  nervous  system.  My  mother  was  a 
very  nervous  woman.  I  had  a  nervous  breakdown  the  second  year 
in  high  school  and  another  near  the  end  of  my  college  work.  I  have 
never  been  in  good  health  since,  and  have  not  had  a  really  good 
night's  sleep  in  twenty  years.  Sometimes  while  trying  a  case,  my 
breathing  seems  to  stop,  my  heart  flutters  and  I  am  tremendously 
alarmed.  The  more  I  think  about  myself.  I  have  found,  the  worse 
I  get.  At  such  times,  if  I  can  retire  to  my  chambers  and  lie  down  for 
ten  or  fifteen  minutes.  I  am  better. 


218  WORRY  AXD  NERVOUSNESS 

One  of  my  worst  troubles  is  that  I  never  know  when  I  have  done 
things.  When  I  address  an  envelope  I  look  at  it  a  dozen  times,  and 
if  I  should  drop  it  in  the  box,  I  would  worry  all  day  over  whether  I 
had  put  a  stamp  on  it  or  not. 

I  live  in  constant  fear  of  losing  my  position  because  of  my  mental 
infirmities.  I  am  positively  childish,  silly,  and  even  superstitious 
over  some  things.  I  understand  it  all  and  I  argue  with  myself  about 
it,  but  it  does  no  good.  I  sign  a  decree  of  the  court  and  in  ten  sec- 
onds I  am  in  doubt  as  to  whether  I  have  signed  the  document  or  not. 
This  anxiety  and  worry  is  literally  driving  me  crazy  —  if  I  am  not 
already  crazy.  Of  course.  I  say  nothing  to  my  associates  about  my 
troubles,  but  I  am  sure  they  know  that  something  is  wrong. 

I  am  a  temperate,  God-fearing  man,  have  always  led  a  regular  and 
upright  life,  and  can't  understand  why  all  these  troubles  should 
plague  me. 

Now,  Doctor,  I  have  a  score  of  other  troubles  I  want  to  tell  you. 
but  before  I  go  any  further.  I  want  to  ask  you  —  and  I  want  you  to 
tell  me  the  truth  —  have  you  ever  had  another  patient  just  like  me? 
Am  I  losing  my  mind  or  what  is  the  trouble,  and  is  there  any  help 
for  a  man  in  such  a  terrible  state? 

TREATMENT   OF    PSYCH  ASTHENIA 

The  treatment  in  general  for  the  neurasthenic  states  will 
be  fully  discussed  in  later  chapters;  but  it  will  be  in  place  to 
give  certain  special  suggestions  at  this  time,  especially  in  re- 
gard to  those  points  where  the  physical  treatment  of  psychas- 
thenia  must  differ  so  radically  from  that  of  neurasthenia. 

Some  time  ago  I  saw  in  consultation  a  psychasthenic  —  a 
woman  thirty-two  years  of  age  —  who  had  been  practically  con- 
fined to  her  bed  for  seven  years,  diagnosed  as  a  neurasthenic 
by  numerous  physicians  and  treated  after  approved  methods  for 
neurasthenia  in  numerous  sanitariums,  all  with  a  net  result 
that  she  was  getting  worse,  or  at  least  no  better,  and  with  the 
experience  that  all  forms  of  physical  treatment,  including  hydro- 
therapy, electricity,  and  massage,  had  never  failed  greatly  to 
aggravate  her  sufferings. 

Such  patients  possess  little  or  no  power  to  react  to  the 
stimulus  of  physiologic  therapeutics.  In  dealing  with  nervous 
disorders,  it  must  be  borne  in  mind  that  the  nerve  cell  does 
not  act  —  it  only  reacts;  therefore,  in  profound  psychasthenia. 


PSYCHASTHEXIA  OR  TRUE  BRAIX  FAG        219 

at  first,  our  remedial  efforts  must  be  wholly  limited  to  psycho- 
therapy. After  a  period  of  nine  months  during  which  the 
patient  was  subjected  to  a  thorough  going  psychotherapeutic 
regime,  it  was  possible  gradually  to  begin  the  employment  of 
much  needed  physiological  procedures,  consisting  of  a  gradu- 
ated course  of  electricity,  massage,  and  hydriatic  measures. 

While  the  details  of  further  treatment  will  be  fully  noted  in 
Part  II  of  this  work,  it  will  not  be  out  of  place  to  say  that  the 
secret  of  success  in  the  practical  cure  of  these  neurologically 
incurable  patients,  consists  in  a  thorough  going  and  protracted 
course  of  mental  training  which  so  changes  the  patient's  view- 
point, that  he  is  able  successfully  to  argue  with  himself  and 
thus  by  and  through  his  own  efforts  actually  to  convince  him- 
self that  his  symptoms,  sufferings,  and  manifold  vagaries,  have 
no  real  foundation  in  fact  beyond  the  presence  of  his  hereditary 
weakened  nervous  system.  And  so,  while  it  is  often  impossible 
entirely  to  obliterate  all  trace  of  their  ailment,  nevertheless, 
they  are  usually  so  greatly  improved  within  a  year  or  eighteen 
months  —  if  they  faithfully  and  intelligently  follow  directions 
—  that  many  come  to  look  upon  themselves  as  practically  cured. 

SUMMARY    OF    THE    CHAPTER 

1.  While  all  psychasthenes  are  more  or  less  neurasthenic, 
and  all  neurasthenes  are  more  or  less  psychasthenic,  neverthe- 
less they  are  entirely  different  disorders. 

2.  Psychasthenia  is  an  hereditary  form  of  mental  fatigue  or 
brain  fag.  It  is  characterized  by  weakness  of  brain  control  and 
emotional  reaction. 

3.  Many  of  the  world's  great  men  of  art,  science,  and  letters 
have  been  more  or  less  psychasthenic. 

4.  In  psychasthenia  the  threshold  of  emotion  has  been  greatly 
lowered  and  the  patient  in  many  ways  seems  to  exercise  a  child- 
ish viewpoint. 

5.  The  psychasthene  reacts  to  his  imaginary  vagaries,  just  as 
fully  and  violently  as  if  they  were  actually  true. 

6.  The  stress  and  strain  that  would  produce  neurasthenia  in 
the  average  person  produces  psychasthenia  in  certain  hered- 
itarily predisposed  individuals. 

7.  Psychasthenia  lies  between  the  less  serious  neurasthenias 
and  the  more  serious  hysterias  and  melancholias. 

8.  Psychasthenia  may  be  classified  as  congenital  or  hereditary, 
and  acquired  or  latent. 


220  WORRY  AND  NERVOUSNESS 

9.  Latent  psychasthenia  often  does  not  appear  until  the  stress 
of  middle  life  or  even  after  its  victim  has  retired  from  business. 

10.  Psychasthenes  are  like  poets,  born,  not  made.  All  classes 
of  society  are  afflicted,  from  the  highest  to  the  lowest. 

11.  When  various  phobias  are  early  manifested  accompanied 
by  enfeebled  will  power  and  brain  fag,  it  is  probably  psychas- 
thenia, not  neurasthenia. 

12.  Psychasthenics  are  "  born  tired  "  and  seldom  get  over  it. 
They  get  along  better  in  the  country  than  in  the  city. 

13.  Many  of  our  common  ne'er-do-wells,  tramps,  and  aristo- 
cratic victims  of  the  ZL'andcrliist  are  in  reality  psychasthenics. 

14.  Many  of  the  brightest  and  shrewdest  of  our  criminals  are 
psychasthenic  in  contrast  with  the  larger,  dull  and  feeble-minded 
class  of  criminals. 

15.  The  chief  symptoms  of  psychasthenia  are  incapacity  for 
doing  things,  coupled  with  over-attention  connected  with  all 
phases  of  living  and  working. 

16.  The  psychasthene  squanders  his  nervous  energy  trying  to 
do  things  that  nature  would  better  accomplish  without  his  as- 
sistance. 

17.  All  introspective  patients  are  not  psychasthenic,  but  all 
psychasthenes  are  introspective. 

18.  They  are  never  certain  that  anything  is  done  right  and  so 
go  over  the  same  ground  again  and  again,  thus  dissipating  energy 
like  the  short  circuiting  of  a  dynamo. 

19.  The  psychasthene  is  impressionable,  timid,  hesitating, 
over-scrupulous,  irritable,  changeable,  and  more  or  less  des- 
pondent. 

20.  The  psychasthene  lives  in  constant  fear  of  losing  his  posi- 
tion, the  respect  of  his  associates,  his  memory,  and  not  infre- 
quently his  mind. 

21.  The  treatment  of  psychasthenia  has  many  things  in  com- 
mon with  that  of  neurasthenia,  except  that  the  psychasthene 
does  not  react  so  well  to  physical  treatments. 

22.  In  the  earlier  stages  of  grave  psychasthenia,  treatment 
must  be  limited  to  suitable  psychotherapeutic  measures. 


CHAPTER  XVIII 
HYSTERIA  — THE  MASTER  IMITATOR 

OF  THE  seven  nervous  states  noted  in  the  first  chapter, 
we  have  already  considered  four  —  chronic  worry,  neu- 
rasthenoidia,  neurasthenia,  and  psychasthenia  —  and  now  come 
to  the  consideration  of  the  fifth  —  hysteria  —  while  hypochon- 
dria and  melancholia  yet  remain. 

HYSTERIA    IN    OLDEN    TIMES 

There  is  little  doubt  in  the  minds  of  medical  men,  but  that 
a  large  part  of  the  so-called  "  demoniacal  possession  "  of  the 
middle  ages,  would  today  promptly  be  diagnosed  as  major  hys- 
teria; while  the  remainder  would  be  regarded  as  some  degree 
of  insanity.  Some  of  our  present  day  hysterics,  had  they  lived 
in  other  centuries,  would  have  been  in  grave  danger  of  being 
burned  for  witchcraft. 

In  past  ages  many  a  great  religious  movement  has  had  its 
origin  in  the  revelations  and  contortions  of  some  earnest  and 
conscientious,  but  manifestly  hysterical,  woman  with  strong 
religious  tendencies.  It  is  only  in  recent  years,  that  we  have 
come  to  understand  the  relations  of  hysteria  to  religion,  insan- 
ity, and  to  some  of  the  far-reaching  national  upheavals  of  past 
ages. 

WHAT  IS  HYSTERIA? 

Hysteria  in  one  form  or  another  is  one  of  the  most  common 
of  nervous  diseases.  Its  name  hysteria  suggests  the  older  and 
erroneous  notion  which  attributed  the  origin  of  this  disease  to 
some  disorder  in  the  female  reproductive  organs.  This  belief 
was  long  ago  shown  to  be  without  foundation,  and  it  is 
now  known  that  men  are  subject  to  hysteria  just  the  same  as 
women. 

221 


222  WORRY  AND  NERVOUSNESS 

Janet  says: 

Hysteria  belongs  to  a  group  of  mental  diseases  caused  by  cerebral 
insufficiency;  it  is  especially  characterized  by  moral  symptoms,  the 
principal  one  being  a  weakening  of  the  faculty  of  psychological  syn- 
thesis. 

The  physician  of  olden  times  looked  upon  hysteria  as  a 
malady  that  was  largely  feigned ;  as  a  fictitious  sort  of  disease 
performance  on  the  part  of  certain  sorts  of  nervous  and  emo- 
tional women.  Men  were  not  supposed  to  have  this  disorder 
and  met  with  but  scant  courtesy  at  the  physician's  hands,  or 
else  they  were  looked  upon  as  being  "  effeminate."  Even  some 
modern  authorities  call  neurasthenia  a  man's  disease,  and  hys- 
teria a  woman's  disease. 

It  is  going  to  be  neither  a  small  nor  easy  task  concisely  to 
define  hysteria  for  the  layman ;  in  fact,  hysteria  is  a  disease 
about  which  we  doctors  disagree  probably  more  than  about  any 
other  common  disorder  to  which  human  flesh  is  heir;  neverthe- 
less, I  am  disposed  to  attempt  to  define  this  interesting  and 
unique  nervous  malady  —  at  least  I  will  give  the  reader  a  defi- 
nition of  this  disturbance  in  accordance  with  my  understanding. 
Hysteria  is  some  sort  of  disorder  in  the  personality,  occurring 
in  hereditarily  predisposed  individuals  who  are  highly  sug- 
gestible on  the  one  hand,  and  who  possess  a  small  degree  of 
self-control  on  the  other.  And  just  here  is  our  difficulty  in 
understanding  hysteria  —  it  has  to  do  with  personality  and  that 
is  a  subject  which  none  of  us  know-  much  about.  An  eminent 
French  physician  once  said  that  a  definition  of  hysteria  had 
never  been  given  and  never  would  be. 

I  may  further  say  that  hysteria  is  a  mental  state  —  possibly  a 
disease  —  largely  due  to  cerebral  insufficiency,  manifesting  it- 
self in  so  many  ways  and  producing  so  many  and  diverse  symp- 
toms as  to  impersonate  almost  every  known  form  of  human 
illness.  It  is  certainly  true  that  a  diseased  and  uncontrolled 
imagination  plays  a  large  part  in  the  cause  and  conduct  of  this 
perplexing  disorder. 

Briefly  summarized  then,  hysteria  is  a  nervous  disorder  oc- 
curring chiefly  in  women ;  characterized  by  lack  of  control  over 
the  emotions  and  certain  physical  acts,  by  morbid  self-conscious- 


HYSTERIA  — THE  MASTER  IMITATOR  223 

ness,  by  exaggeration  of  all  sensory  impressions,  and  by  an 
extraordinary  ability  to  simulate  the  symptoms  of  numerous 
diseases,  and  thus  to  impersonate  a  host  of  minor  and  major 
disturbances. 

IMAGINATION"    AS    AN    ACTOR 

Human  imagination  is  a  marvelous  actor.  The  ability  to 
impersonate,  the  power  to  think  and  feel  and  act  as  another 
person  would  think  and  feel  and  act,  constitutes  both  the  stock 
and  trade  and  the  secret  of  success  of  the  emotional  actress. 
But  what  sort  of  a  state  of  affairs  would  we  have  if  the  actress 
while  on  the  stage  and  in  the  midst  of  the  play,  should  become 
so  muddled,  or  should  so  succumb  to  her  imagination,  that  she 
should  actually  believe  herself  to  be  in  truth,  the  very  character 
she  was  endeavoring  to  impersonate?  And  that  is  exactly  the 
sort  of  prank  that  suggestion  and  imagination  play  upon  the 
hysterical  patient.  Hysteria  is  merely  an  actor  who  tempo- 
rarily has  lost  his  head,  but  goes  on  playing  his  part  thinking  it 
to  be  real. 

Hysteria  is  a  breakdown  in  that  normal  and  necessary  co- 
operation and  coordination  between  the  sensory  or  voluntary 
nervous  system  and  the  great  sympathetic  or  involuntary  nerv- 
ous mechanism,  thereby  resulting  in  great  disturbances  of 
sensation  and  unusual  disorder  in  the  motor  control  of  the 
body.  Hysterical  attacks  might  thus  be  regarded  as  a  mild 
and  temporary  form  of  physical  or  bodily  insanity,  resulting 
from  the  decreased  or  deranged  control  of  the  sympathetic 
nervous  system  on  the  part  of  the  cerebro-spinal  system.  And 
it  is  exactly  this  disturbance  in  the  delicate  balance  between 
these  two  nervous  systems  that  is  responsible  for  the  production 
of  that  vast  concourse  of  symptoms  which  are  able  so  to  group 
themselves  as  to  suggest  almost  all  forms  of  every  known 
disease. 

COMPLEX    DISSOCIATION 

A  psychic  complex  is  a  sort  of  community  or  constellation  of 
brain  cells,  which  are  functionally  more  or  less  related  and 
associated.  These  so-called  complexes  or  aggregations  of 
thinking  units  are  more  or  less  coordinated  and  loosely  organ- 
ized into  working  groups  and  systems. 


224  WORRY  AND  NERVOUSNESS 

Some  authorities  look  upon  hysteria  as  a  sort  of  temporary 
dissociation  between  certain  important  complexes  or  groups  of 
complexes.  The  consciousness  of  the  individual  is  thus  de- 
prived of  the  coordinate  and  simultaneous  directing  influence  of 
these  distracted  and  diverted  mind  centers;  and  it  is  just  this 
derangement  which  is  responsible  for  that  demoralized,  dis- 
organized, and  incoordinate  mental  and  physical  behavior  of  the 
patient  as  exhibited  in  a  typical  hysterical  attack.  A  severe 
attack  of  hysteria  would,  according  to  this  theory,  closely  border 
on  that  interesting  phenomenon  of  dissociation  of  personality, 
multiple  personality,  etc. 

In  the  presence  of  this  temporary  sort  of  complex  dissociation, 
it  would  appear  that  in  the  case  of  these  highly  suggestible 
individuals,  that  some  sort  of  dominating  and  all-pervading 
idea  —  now  free  from  natural  restraints  and  customary  restric- 
tions —  sweeps  through  the  mind  and  out  over  the  body,  com- 
pletely dominating  and  absolutely  controlling  the  organism  to 
such  an  extent  as  to  be  able  to  produce  cramps,  paralyses,  and 
fits,  as  regards  the  body;  while,  in  a  mental  way,  the  patient 
may  become  as  one  possessed  of  the  devil  on  the  one  hand, 
while  on  the  other  hand,  she  may  go  forth  in  some  noble  and 
daring  role  as  did  the  heroic  maid  of  Orleans. 

CAUSES   OF    HYSTERIA 

While  the  causes  of  hysteria  are  many,  there  is  usually  to 
be  found  both  an  hereditary  base  and  some  exciting  physical 
cause.  Hysteria  is  especially  prone  to  manifest  itself  at  the 
adolescent  period  of  life.  It  seldom  makes  its  first  appearance 
after  twenty-five  or  thirty  years,  and  it  is  exceedingly  rare 
after  forty-five.  It  is  found  about  equally  divided  between  the 
two  sexes.  In  the  lower  classes  of  society  more  cases  appear 
among  men,  while  in  the  higher  social  class,  women  predom- 
inate. The  disorder  appears  in  all  countries  and  all  races,  but 
the  Latin,  Slav,  and  Jewish  races  seem  to  be  more  susceptible. 

Chief  among  the  exciting  causes  are  the  various  emotional 
disturbances  such  as  worry,  grief,  chagrin,  and  fright.  In  fact 
it  has  been  my  experience  that  in  a  very  large  number  of 
cases,  by   careful   investigation,  we   are   usually   able   to  trace 


HYSTERIA  — THE  MASTER  IMITATOR  225 

hysteria  back  to  some  pre-adolescent  fright.  Sometimes  a 
number  of  bad  scares  or  other  harrowing  experiences  may  be 
grouped  together  as  a  cause  of  a  later  appearing  hysteria.  These 
psychic  traumatisms  are  responsible  for  producing  a  sort  of 
subconscious  panic  in  the  controlling  and  discriminating  centers 
of  the  mind,  and  are  thus  able  quite  unknown  to  the  patient, 
to  precipitate  these  subsequent  typical  hysterical  seizures. 
These  frights  may  be  such  common  occurrences  as  a  mad-dog 
scare,  a  runaway,  lightning  stroke,  and  other  sorts  of  tragic 
accidents. 

The  next  most  important  groups  of  exciting  causes  are  found 
to  be  intoxications  of  various  sort  —  chronic  poisoning  by  lead, 
mercury,  tobacco,  morphine,  cocaine,  or  alcohol.  It  is  in  this 
way  that  the  infectious  diseases,  such  as  typhoid,  diphtheria, 
influenza,  etc.,  predispose  certain  susceptible  persons  to  hys- 
terical attacks.  It  sometimes  develops  that  the  toxemia  of 
chronic  diseases  works  after  the  same  manner  as  in  tuber- 
culosis, diabetes,  syphilis,  cancer,  etc. 

IMITATION     AND    SUGGESTION 

The  next  most  important  group  of  causes  may  be  classed 
under  the  head  of  association  and  suggestion.  Young  people 
when  associated  together,  as  in  boarding  schools,  may  suffer 
from  epidemic  attacks  of  hysteria  as  a  result  of  suggestion  and 
imitation.  Even  predisposed  adults,  as  a  result  of  physical  or 
mental  overwork,  and  under  the  influence  of  a  powerful  sug- 
gestion associated  with  some  protracted  religious  meeting,  may 
develop  those  hysterical  attacks  which  are  characterized  by 
dancing,  spasms,  crying,  and  other  emotional  manifestations 
which  so  frequently  accompany  intense  religious  excitement, 
especially  in  rural  districts  which  are  ordinarily  so  quiet  and 
tranquil. 

We  must  not  forget  that  in  hysteria  as  in  neurasthenia  and 
psychasthenia,  the  real  basis  of  the  disorder  rests  upon  the 
hereditary  instability  of  the  nervous  system,  and  that  these 
patients  are  also  victims  of  that  chronic  mental  fatigue  and 
ever  present  physical  tiredness.  And  all  this  creates  the  ideal 
state  of  mind  and  body  which  makes  it  so  easy  for  suggestion 


226  WORRY  AND  NERVOUSNESS 

to  do  its  evil  work ;  especially  is  this  true  in  those  patients  who 
are  victims  of  their  own  suggestions  —  autosuggestion.  On  the 
other  hand,  the  very  fact  that  these  patients  are  so  highly 
suggestible,  enables  the  physician  the  more  easily  to  gain 
control  over  them  and  thus,  in  proper  hands,  proves  of  real 
value  in  bringing  about  their  recovery. 

AFFECTIONS   AND   EMOTIONS 

Dubois  thinks  that  the  periodical  sex  cycles  in  the  woman 
really  have  something  to  do  with  the  production  of  hysteria  in 
certain  susceptible  individuals.     He  says: 

Even  in  the  normal  woman  there  is  some  derangement  in  the 
psychic  life  during  the  menstrual  period;  there  are  special  sensi- 
bilities which  are  foreign  to  the  mentality  of  the  male,  and  which  we 
have  never  been  able  to  comprehend.  I  am  led  to  believe  that  the 
various  vague,  conscious,  or  unconscious  sensations  which  pertain  to 
the  sexual  instinct  play,  even  in  the  virgin  of  the  most  immaculate 
thoughts,  a  considerable  role  in  the  genesis  of  hysteria.  But  they 
produce  unhealthy  autosuggestions  only  in  the  subjects  so  predis- 
posed and  those  of  weak  mentality;  the  hysterical  person  is  also 
psychasthenic. 

Experience  has  more  and  more  forced  me  to  recognize  that 
unrequited  love,  unsatisfied  emotional  longings,  together  with 
other  disappointments  and  repressions  of  the  affections  and  the 
passions,  must  be  regarded  as  the  prime  cause  of  hysteria  in 
many  youth,  especially  young  women. 

SYMPTOMS  OF   HYSTERIA 

As  before  noted,  this  protean  malady  is  able  to  produce 
symptoms  which  simulate  practically  almost  every  known  dis- 
ease. It  is  obviously  impossible  to  undertake  to  catalogue  all  the 
manifestations  of  hysteria  in  this  chapter.  It  is  customary  to 
divide  these  symptoms  of  hysteria  into  two  groups,  viz. :  the 
stigmata  or  constant  symptom,  and  the  accidental  or  transient 
manifestation. 

The  stigmata  or  chief  symptom  of  hysteria  may  be  considered 
under  three  heads: 

I.  Sensory  stigmata.     The  typical  hysterical  patient  usually 


HYSTERIA  — THE  MASTER  IMITATOR  227 

presents  symptoms  of  anaesthesia  —  loss  of  skin  sensation  over 
certain  portions  of  the  body  —  sometimes  involving  an  entire 
half  of  the  body  (usually  the  left  side).  There  is  also  some- 
times an  absence  of  feeling  in  the  deeper  tissues  and  organs  of 
the  body.  The  senses  of  taste  and  smell  are  frequently  per- 
verted, diminished,  or  even  abolished.  Hearing  may  be  so 
diminished  as  to  produce  the  familiar  hysterical  deafness;  like- 
wise the  vision  may  be  so  disordered  as  to  result  in  a  long  list 
of  sight  disturbances  some  of  which  are  very  alarming  to  the 
patient,  culminating  in  the  characteristic  temporary  hysteric 
blindness. 

These  zones  of  disordered  feelings  in  hysterics  are  usually 
movable,  although  they  may  apparently  remain  stationary  for 
many  years.  An  interesting  point  in  this  connection,  and  one 
greatly  concerned  in  the  diagnosis  of  hysteria,  is,  that,  in  spite 
of  these  disturbances  and  loss  of  sensation,  the  eye  reflexes 
in  their  response  to  light  and  the  tendon  reflexes,  as  shown 
by  the  knee  jerk,  are  always  present  and  are  practically  normal. 

In  contrast  with  anaesthesia,  many  patients  present  conditions 
of  hyperaesthesia.  They  often  complain  of  neuralgic  pains. 
They  have  painful  hysteric  joints.  They  are  especially  prone 
to  complain  of  pain  in  the  breast,  spine,  pit  of  stomach,  and 
ovaries;  and  twenty  years  ago,  many  a  young  woman  was  sub- 
jected to  a  surgical  operation  for  the  removal  of  the  ovaries  for 
no  other  cause  than  the  fact  that  she  was  a  victim  of  hysterical 
ovarian  pain. 

2.  Motor  stigmata.  Common  ordinary  muscular  movements 
in  the  hysteric  are  usually  retarded.  They  suffer  from  a  char- 
acteristic slowness  of  action,  together  with  more  or  less  inco- 
ordination. They  are  also  quite  incapable  of  performing  two 
or  more  actions  simultaneously.  All  voluntary  actions  are  more 
or  less  weakened,  and  the  patient  manifests  a  tendency  to 
transient  rigidities,  muscular  cramps,  and  even  prolonged  con- 
tractures. Catalepsy  may  be  the  culmination  of  these  numerous 
motor  disturbances. 

3.  Mental  stigmata.  The  chief  and  most  characteristic  mental 
symptom  of  hysteria  is  amnesia  —  forgetfulness.  The  hysterical 
patient  may  show  a  very  poor  memory  regarding  certain  things 


228  WORRY  AND  NERVOUSNESS 

or  as  pertaining  to  certain  individuals,  while  the  memory  may 
be  entirely  normal  as  regards  other  matters  and  other  persons ; 
and  this  explains  just  why  they  so  often  lay  themselves  open 
to  the  charge  of  deceit  and  prevarication.  This  infirmity  is 
spoken  of  as  systematized  memory  loss.  Memory  disturbance 
in  other  patients  seems  to  be  localized;  that  is,  following  a  bad 
attack,  they  temporarily  lose  their  memory  as  regards  events 
antecedent  to  the  attack  for  a  variable  period  of  time.  In  this 
respect,  in  a  minor  way,  the  hysteric  comes  closeiy  to  resemble 
those  cases  of  memory  lapse  which  are  characteristic  of  multiple 
personality;  and  this  is  not  strange  in  view  of  the  fact  that  both 
conditions  —  hysteria  and  multiple  personality  —  are  supposed 
to  have  their  origin  in  complex  dissociation. 

The  chief  of  the  other  mental  stigmata  may  be  mentioned  as 
diminution  or  complete  loss  of  will  power  (aboulia),  greatly 
increased  impressionability,  and  that  characteristic  tendency 
to  imitate  and  simulate. 

THE   SIMULATIONS   OF    HYSTERIA 

The  so-called  accidental  symptoms  of  hysteria  are  usually  so 
grouped  and  manifested  as  to  simulate  the  clinical  picture  of 
some  other  disease.  And  it  will  be  best  to  consider  them  in 
that  light  at  this  time.  The  fact  that  the  patient  is  so  largely 
self-occupied  explains  how  these  hysterical  symptoms  come  en- 
tirely to  fill  up  consciousness;  and  in  accordance  with  the  laws 
of  the  threshold  of  pain,  previously  considered,  it  will  be  easy 
to  understand  how  the  hysteric's  common  sensations  may  be 
transmuted  into  a  veritable  avalanche  of  suffering. 

These  patients  are  indeed  a  "  fastidious  "  class.  They  are 
both  unbalanced  and  erratic,  and  their  life  experience  is  marked 
off  by  certain  well  defined  "  crises."  These  characteristic  and 
impulsive  explosions  are  not  at  all  unlike  the  periodical  catas- 
trophies  of  the  inebriate,  especially  as  regards  the  uncontrollable 
and  rhythmic  behavior  of  the  attacks. 

It  should  be  remembered,  as  we  now  take  up  these  hysterical 
attacks  that  there  very  often  exists  some  trifling  physical  basis 
for  these  manifestations,  which,  in  connection  with  the  nervous 
and  mental  state,  is  able  to  determine  the  particular  and  definite 


HYSTERIA  — THE  MASTER  IMITATOR  229 

form  which  the  hysterical  manifestation  assumes  from  time  to 
time. 

1.  Gastric  Crisis.  There  are  sudden  seizures  of  stomach  pain, 
behaving  almost  identical  with  those  of  the  gastric  crises  of 
locomotor  ataxia.  Other  cases  are  limited  to  a  sudden  and 
unusual  appearance  of  gas  in  the  stomach  and  bowels  accom- 
panied with  severe  colic.  These  patients  also  sometimes  suffer 
from  a  rectal  crisis  and  experience  great  pain. 

2.  Vomiting  Crisis.  These  attacks  of  repeated  vomiting  are 
very  alarming  to  the  patient's  friends.  They  sometimes  appear 
without  the  slightest  excuse,  but  it  is  observed  that  they  usually 
stop  before  the  patient  has  experienced  the  loss  of  much  flesh. 
Closely  akin  to  this  manifestation  may  be  noted  the  fasting 
fads  of  the  hysterical  patient.  They  not  infrequently  go  a 
week  or  ten  days  without  eating.  I  am  of  the  opinion  that  most 
of  those  cases  who  appear  to  have  gone  without  eating  for  a 
longer  period,  were  probably  getting  food  on  the  sly. 

3.  Secretory  Crisis.  Hysterical  patients  are  subject  to  sudden 
attacks  of  both  increase  and  decrease  in  the  bodily  secretions, 
accompanied  by  paroxyms  of  pain  and  attacks  of  vomiting;  this 
condition  may  involve  the  stomach,  liver,  bowels,  or  kidneys ;  in 
the  latter  case,  the  urine  may  become  scant  or  be  greatly 
increased  in  quantity. 

4.  Appendicitis  Crisis.  The  patient  is  seized  with  the  typical 
symptoms  of  acute  appendicitis,  and  the  puzzling  part  of  the 
proposition  is  the  fact  that  the  patient's  temperature  may  some- 
times shoot  right  up  to  I02°-I04°.  I  no  longer  doubt  or 
question  the  existence  of  this  so-called  ''hysterical  fever.''  The 
diagnosis,  of  course,  can  be  differentiated  by  the  history  of  the 
case  and  an  examination  of  the  blood ;  however,  there  is  a  case 
on  record  of  a  hysterical  patient  who  had  five  operations  for 
appendicitis,  during  the  last  of  which,  the  surgeon  tatooed  on 
the  patient's  abdomen  this  surgical  warning,  "  Xo  appendix 
here." 

5.  Gallstone  Crisis.  This  fictitious  gallstone  colic  has  led 
careless  surgeons  into  the  performance  of  many  a  useless  opera- 
tion. It  is  very  common  for  these  patients  to  think  they  have 
gallstones,   and   it  is  only  by  painstaking  and  thorough- going 


230  WORRY  AXD  NERVOUSNESS 

examinations,  that  the  physician  will  be  able  to  avoid  serious 
diagnostic  blunders  in  dealing  with  these  deceptive  sufferers. 

6.  Renal  Colic  Crisis.  The  patient  is  able  to  present  all  the 
symptoms  of  stone  in  the  kidney  and  of  stone  passing  down  the 
ureter,  with  the  exception  that  in  a  real  case  the  urine  is  sup- 
pressed while  in  hysteria  there  is  usually  a  greatly  increased  flow. 
In  these  cases,  too,  many  an  operation  has  been  performed,  but 
no  stone  has  been  found  in  the  kidney. 

7.  The  Headache  Crisis.  These  attacks  of  headache  are  often 
so  severe  and  persistent  as  to  suggest  brain  tumor.  It  is  a  com- 
mon experience  to  have  a  patient  come  to  us  who  is  rather 
under-nourished,  suffering  from  poor  circulation,  generally 
nervous,  highly  emotional,  and  giving  a  history  of  having 
frequent  "  nervous  spells."  Such  a  hysterical  sufferer,  often 
complains  of  violent  headaches  which  she  describes  as  follows: 
"Doctor,  when  I  get  these  dreadful  headaches,  it  just  seems  as 
if  someone  were  driving  a  nail  right  into  the  top  of  my  head. 
It  is  something  terrible  and  it  nearly  drives  me  crazy,  and  I 
think  it  has  a  whole  lot  to  do  with  my  nervous  spells." 

This  is  a  truly  characteristic  description  of  the  headache  of 
hysteria.  This  is  a  rare  form  of  severe  nervous  headache. 
There  are  other  nervous  states  such  as  epilepsy,  etc.,  in  which 
the  patient  describes  a  similar  pain. 

This  hysterical  headache  is  treated  by  applying  very  hot 
fomentations  on  top  of  the  head  for  ten  or  fifteen  minutes. 
These  hot  applications  should  be  repeated  every  one  or  two 
hours  in  connection  with  a  very  hot  foot  bath.  Such  sufferers 
are  usually  greatly  benefited  by  taking  a  warm  bath  at  about 
100  degrees.  This  bath  tends  to  quiet  the  nervous  system  and 
greatly  relieves  the  patient's  sufferings. 

8.  Pain  Crisis.  In  other  cases  the  hysterical  outbreak  mani- 
fests itself  as  an  explosion  of  pain  —  an  avalanche  of  suffering. 
It  may  be  an  earache,  pains  in  the  arms,  the  legs  or  some  internal 
organ,  or  even  in  a  joint.  In  the  milder  cases  the  pain  may  be 
described  as  a  soreness  or  a  "  deep  ache " ;  while  following 
these  painful  attacks  the  patient  usually  complains  of  great 
muscular  fatigue.  Pain  may  center  in  some  internal  organ  such 
as  the  heart  —  giving  rise  to  pseudo-angina  pectoris. 


HYSTERIA  — THE  MASTER  IMITATOR  231 

9.  Motor  Crisis.  These  are  the  fits,  spells,  and  spasms  of 
hysteria.  They  may  imitate  convulsions,  St.  Vitus'  dance,  or 
epilepsy.  They  embrace  those  cases  of  muscular  paralysis  or 
hysterical  palsies,  and  the  patient  is  sometimes  unable  to  stand 
or  walk,  while  for  years  at  a  time  he  may  suffer  from  hysterical 
joints,  the  hip  and  the  knee  being  the  joints  more  usually 
involved.  They  present  tremors  that  resemble  exophthalmic 
goitre.  They  experience  laughing,  crying,  and  choking  attacks, 
and  often  create  internal  tumors  which  are  as  hard  and  fixed 
as  to  deceive  the  surgeon  into  the  performance  of  an  operation 
—  if  he  neglects  the  precaution  of  putting  the  patient  into  a 
prolonged  hot  bath  first.  This  usually  causes  the  tumor  to 
vanish. 

HYSTERICAL    ATTACKS 

The  average  hysterical  patient  who  is  subject  to  mild  attacks, 
complains  of  numbness  of  the  tongue,  bad  taste,  prickling  sensa- 
tions in  the  side  of  the  face,  ringing  in  the  ears  and  headaches. 
At  other  times  he  will  suffer  from  twitching  in  the  back  of 
the  neck  and  a  fluttering  sensation  in  the  throat,  with  now  and^ 
then  a  general  seizure  resembling  a  mild  convulsion.  He  seldom 
completely  loses  consciousness.  These  attacks  are  usually  first 
brought  on  by  some  definite  fright.  At  other  times  the  symp- 
toms may  originate  in  the  stomach  or  by  a  crawling  feeling 
ascending  the  spine.  The  patient  gets  cold,  nauseated,  or  may  be 
attacked  by  a  choking  sensation.  These  seizures  may  crystallize 
into  any  on©  of  the  groups  or  crises  already  described.  And 
yet  when  the  patient  is  examined  during  the  interval  between 
these  attacks  —  while  the  symptoms  which  were  manifested  at 
the  crisis  are  absent  —  the  physician  is  always  able  to  detect 
certain  ear-marks  of  hysteria,  the  "  stigmata "  previously 
described. 

When  the  disease  is  at  its  worst,  the  patient  suffers  from 
what  the  physicians  call  "  grand  attacks,"  and  these  seizures  are 
really  divided  into  five  periods. 

1.  The  Prodromal  Stage.  This  is  characterized  by  unusual 
depression  or  exhilaration,  by  moodiness  or  restlessness,  also 
by  disturbances  of  sight  and  hearing,  circulatory  disturbances, 


232  WORRY  AXD  NERVOUSNESS 

nausea,  hiccough,  trembling,  and  the  passing  of  a  large  quantity 
of  urine,  all  of  which  culminates  in  the  appearance  of  the 
fatal  aura —  that  is,  the  feeling  of  something  arising  from  the 
abdomen  like  a  rounded  body,  which  slowly  mounts  upward  until 
on  reaching  the  neck,  it  gives  origin  to  those  feelings  of  strangu- 
lation and  suffocation,  the  globus  hystericus. 

2.  The  E pile pt oid  Period.  This  closely  resembles  a  mild 
epileptic  attack.  The  tongue  may  protrude,  but  it  is  seldom  if 
ever  bitten.  The  face  is  drawn  to  one  side.  The  spasms  usually 
last  from  one  to  two  minutes.  Unlike  epilepsy,  the  feet  are 
extended  and  the  hands  are  moved  in  circles.  After  one  or 
two  minutes,  more  rapid  oscillations  begin  in  the  muscle,  espe- 
cially the  face,  while  the  patient  begins  to  gasp  and  sob. 

3.  The  Period  of  Clownism.  A  period  of  contortions,  atti- 
tudes, and  movements  sometimes  accompanied  by  violent  out- 
cries and  expressive  of  evident  fear  and  rage.  This  is  the 
phase  in  which  the  patient  is  often  given  to  biting  and  striking. 

4.  Period  of  Passional  Attitudes.  In  this  the  patient  drama- 
tizes in  pantomine  the  fears  and  experiences  which  dominate 
the  consciousness  in  association  with  the  hysterical  attack. 

5.  Period  of  Delirium.  This  period  may  last  from  a  few  mo- 
ments to  several  hours.  The  patient  talks  of  his  hallucinations 
and  sufferings.  And  after  much  sobbing  and  crying  followed 
by  a  few  moments'  silence,  consciousness  is  quickly  recovered 
and  the  "grand  attack"  is  over,  having  lasted  from  fifteen 
minutes  to  half  an  hour. 

SPECIAL  TREATMENT   OF   HYSTERIA 

In  general,  hysteria  must  be  treated  by  those  methods  of  will- 
training  which  will  be  fully  dealt  with  in  Part  11  of  this  work. 
But  brief  suggestions  will  be  given  in  this  chapter,  first  of 
which  is  the  caution  not  to  confuse  some  serious  organic  disease 
with  hysteria,  or  to  overlook  such  a  serious  disorder  if  present 
as  a  complication  of  hysteria.  Such  a  mistake  in  diagnosis  is 
usually  avoided  by  careful  study  of  the  heredity  and  history 
of  the  patient,  together  with  a  physical  examination  which 
usually  discloses  the  characteristic  anaesthetic  or  hyperaesthetic 
skin  spots  together  with  other  typical  "  hysterical  stigmata." 


HYSTERIA  — THE  MASTER  IMITATOR  233 

During  the  attack  an  effort  should  be  made  to  divert  the 
patient's  concentrated  attention.  Vigorous  threats  and  other 
spectacular  stunts  may  be  effective  at  first,  but  they  soon  lose 
their  influence.  In  fact  there  is  very  little  treatment  to  be 
suggested  during  the  attack  itself. 

Between  attacks  the  patient's  treatment  is  both  physical  and 
mental.  Physically,  fresh  air,  good  food,  and  exercise,  together 
with  modified  rest-cure  in  certain  cases,  are  the  remedial  agents 
of  greatest  value. 

The  mental  treatment  may  be  summarized  as  follows: 

1.  Explain  to  the  patients  the  real  facts  —  show  them  the 
true  origin  of  their  troubles. 

2.  Assist  them  in  isolating  the  exciting  causes  such  as  love 
affairs,  family  troubles,  sorrow,  and  any  other  dominant  sub- 
conscious idea. 

3.  Seek  out,  isolate,  and  eliminate  buried  experiences,  such 
as  early  childhood  frights,  vivid  dreams,  etc. 

4.  The  patient  will  be  cured  by  will-training,  coupled  with 
diverting  the  attention  and  sympathies  to  children  and  other 
helpless  people. 

SUMMARY   OF    THE    CHAPTER 

1.  In  olden  time  hysteria  was  confounded  with  demoniacal 
possession,  insanity,  witchcraft,  and  accompanied  religious  ex- 
citement and  national  upheavals. 

2.  Both  men  and  women  are  affected  with  hysteria.  It  is  a 
disorder  resulting  from  cerebral  insufficiency.  It  is  not  a 
woman's  disease,  as  the  name  suggests. 

3.  Hysteria  is  a  disorder  of  personality  in  hereditarily 
predisposed  and  highly  suggestive  individuals  with  little  self- 
control. 

4.  Hysteria  is  characterized  by  riotous  emotions,  morbid  self- 
consciousness,  exaggerated  sensations  and  simulations  of  various 
diseases. 

;.  Hysteria  is  an  actor  who  has  lost  his  head  and  thinks  the 
part  he's  playing  is  real. 

6.  Physically,  hysteria  is  a  derangement  in  the  normal  and 
delicate  balance  between  the  cerebro-spinal  and  the  sympathetic 
nervous  systems. 

7.  Hysteria  may  be  due  to  complex  dissociation,  and  would 
thus  be  regarded  as  related  to  a  mild  and  temporary  form  of 
dissociation  of  personality. 


234  WORRY  AND  NERVOUSNESS 

8.  The  chief  causes  of  hysteria  are  hereditary  predisposition, 
and  pre-adolescent  frights  —  a  series  or  group  of  frights. 

9.  These  early  emotional  shocks  produce  a  sort  of  sub-con- 
scious panic  resulting  in  demoralized  emotional  and  motor 
control. 

10.  Among  other  causes  of  hysteria  may  be  mentioned  intoxi- 
cation and  chronic  poisoning,  resulting  from  drugs  and  from 
acute  and  chronic  disease  toxins. 

11.  Imitation  hysteria  may  appear  in  boarding  schools,  and 
may  accompany  intense  religious  excitement,  manifesting  itself 
in  dancing,  spasms,  crying,  etc. 

12.  Repressed  emotions  and  disappointed  affections,  together 
with  the  periodic  sex  cycles  of  women,  are  all  contributary  causes 
of  hysteria. 

13.  The  major  symptoms  of  hysteria  (stigmata)  are  a  group 
of  characteristic  motor,  mental,  and  sensory  disturbances. 

14.  Sensory  disturbances  arc  :  anaesthesia,  hyperesthesia,  dis- 
orders of  taste,  smell,  and  hearing,  and  numerous  other  abnormal 
sensations  and  feelings. 

15.  Common  motor  stigmata  are  retardation  and  incoordina- 
tion of  muscular  movement,  together  with  rigidities,  cramps, 
contractions,  and  even  catalepsy. 

16.  The  chief  mental  stigmata  are  forgetfulness,  freaks  of 
memory,  diminution  of  will  power  with  marked  tendency  to 
imitate  and  simulate. 

17.  The  "attacks"  of  hysteria  usually  simulate  some  well- 
known  disease  and  behave  somewhat  after  the  manner  of  the 
crisis  of  periodical  inebriety. 

18.  Hysterical  attacks  commonly  appear  as  a  "  gastric  crisis," 
"  rectal  crisis,"  "  colic  crisis,"  "  vomiting  crisis,"  and  secretory 
disturbances. 

19.  Other  attacks  may  simulate  appendicitis,  gallstone  crisis, 
and  the  passing  of  stones  from  the  kidney. 

20.  Pain  is  a  constant  symptom,  chiefly  manifested  as  a  charac- 
teristic headache,  but  no  part  of  the  body  is  exempt. 

21.  The  "motor  crisis"  are  fits  and  spells  which  may  imitate 
convulsions,  chorea,  epilepsy,  and  paralysis. 

22.  Hysteria  seizures  are  divided  into  the  mild  or  minor  crisis, 
and  the'"  grand  attacks  "  lasting  from  fifteen  to  thirty  minutes. 

23.  The  "  grand  attacks "  of  hysteria  are  divided  into  five 
periods;  viz.,  prodromal,  epileptoid,  clownism,  passional  atti- 
tudes, and  delirium. 

24.  The  treatment  of  hysteria  consists  of  diverting  the  atten- 
tion, directing  the  emotions,  training  the  will,  removing  fear,  and 
finding  new  objects  for  love  and  sympathy. 


CHAPTER  XIX 
HYPOCHONDRIA  AND  MELANCHOLIA 

SOME  authorities  do  not  distinguish  between  hypochondria 
and  melancholia.  They  simply  recognize  a  simple  melan- 
cholia or  hypochondria  and  the  more  serious  melancholia  which 
is  one  of  the  stages  of  "  maniac-depressive  insanity."  In  pre- 
senting these  disorders  to  the  layman,  I  prefer  to  retain  a 
classification  that  recognizes  hypochondria  as  a  comparatively 
innocent  and  harmless  variety  of  mental  depression,  in  contrast 
with  melancholia,  which  undoubtedly  leads  us  into  the  border- 
land of  the  more  serious  and  well-defined  aspects  of  the  early 
and  milder  insanities. 

THE  BLUES 

The  most  simple  form  of  periodical  depression  is  that  com- 
monly known  as  the  "  blues  "  —  a  sort  of  acute  attack  of  mild 
hypochondria.  It  is  a  combined  mental  and  physical  condition 
characterized  by  loss  of  appetite,  disturbed  sleep,  disinclination 
for  physical  exercise,  and  a  great  increase  in  the  intensity  of 
one's  aches  and  pains.  It  is  a  condition  thought  by  many 
authorities  to  be  greatly  aggravated  by  portal  (liver)  congestion, 
chronic  constipation,  etc.,  and  for  this  reason  has  sometimes  been 
called  "  splanchnic  neurasthenia."  Periodical  depression  in  this 
mild  form  is  difficult  to  classify,  and  may  very  properly  be  looked 
upon  as  a  specialized  form  of  nervous  exhaustion. 

WHAT   IS    HYPOCHONDRIA? 

Many  years  ago  it  was  noticed  that  certain  patients  became 
inordinately  depressed  —  the  depression  continuing  from  three 
to  six  months  at  a  time  —  while  the  interval  of  fairly  normal 
health  would  last  from  six  months  to  a  year.  In  some  cases  the 
hypochondria  was  light,  but  too  well  defined  to  be  called  an 

235 


236  WORRY  AND  NERVOUSNESS 

attack  of  the  "blues."  On  the  other  extreme,  certain  of  the 
more  profound  hypochondrias  we  now  classify  as  melancholia, 
and  frankly  recognize  them  as  a  part  of  "  circular  insanity." 
But  in  between  the  common  blues  of  the  functional  nervous 
states  and  the  melancholic  hypochondria  of  insanity,  we  have  a 
well  denned  state  of  depression  which  is  often  amenable  to 
combined  mental  and  physical  treatment,  and  for  which  we 
prefer  to  retain  the  name  and  classification  of  "  simple  hypo- 
chondria." 

In  addition  to  the  characteristic  mental  depression  and  anxious 
countenance  of  the  patients,  they  suffer  from  a  variety  of  fixed 
pains.  When  we  find  a  patient  who  insists  on  tormenting  himself 
with  a  large  assortment  of  self-inflicted  ills,  and  who  at  the 
same  time  is  not  definitely  melancholic,  and  who  evidences  no 
suicidal  tendencies,  then,  as  I  say,  I  prefer  to  call  the  case  one 
of  hypochondria. 

It  is  the  patients'  tendency  to  exaggerate  all  their  physical 
suffering  that  affords  the  clue  to  diagnosis.  And  not  only  that, 
but  when  they  have  no  disease  at  all,  they  make  a  special  business 
of  having  it  any  way.  Their  complaints  are  out  of  all  propor- 
tion to  the  cause.  They  are  constantly  preoccupied  with  their 
own  troubles,  inordinately  self  centered,  and  introspective  to  the 
highest  degree. 

CHRONIC  GRIEF 

Some  forms  of  depression  are  due  to  passing  or  transient 
causes  and  would  better  be  classified  as  "  chronic  grief,"  and 
while  the  doctor  cannot  cure  these  cases,  he  can  always  offer 
consolation  —  comfort  resting  upon  a  sound  basis  of  reasoning 
—  consolation  that  is  even  more  apt  to  appeal  to  the  patient 
than  that  offered  by  the  clergy. 

The  causes  of  prolonged  grief  may  be  natural  or  unnatural; 
that  is,  the  bereaved  mother  may  grieve  over  the  loss  of  an  only 
child  and  this  we  would  regard  as  but  natural  and  would  expect 
that  time  would  heal  the  hurt ;  but,  when  the  mother  unduly  and 
unusually  prolongs  and  intensifies  her  grief,  and  gives  as  her 
reason  for  so  doing  that  she  believes  the  child  was  taken  away 
as  a  providential  punishment  for  her  personal  sins,  or  when  she 


HYPOCHONDRIA  AXD  MELANCHOLIA         237 

comes  to  believe  she  had  or  has  committed  the  unpardonable 
sin,  etc.,  then  we  may  recognize  a  case  of  abnormal  or  unnatural 
grief  —  one  closely  approaching  hypochondria  or  melancholia. 

These  unusual  cases  of  grief  usually  appear  in  patients  who 
are  predisposed  by  both  heredity  and  poor  health.  The  important 
thing  to  do  for  these  patients  is  to  raise  the  vitality,  to  keep 
up  the  nutrition  and  endeavor  to  show  them  that  such  experi- 
ences are  but  common  everyday  episodes  in  the  regular  order  of 
existence  on  this  planet. 

CAUSES  OF  DEPRESSION 

Hypochondria  often  results  from  a  combination  of  physical 
illness  and  a  chronic  habit  of  fearful  doubting.  Too  many  people 
are  like  Shakespeare's  Hamlet  —  they  are  constitutionally 
doubters.  A  chronic  state  of  depression  is  sometimes  brought 
on  by  a  sudden  loss  of  position  or  fortune.  On  the  other  hand, 
the  enforced  idleness  of  the  retired  business  man  or  society 
woman  tends  to  the  development  of  introspection,  and  this 
morbid  self-examination  culminates  in  hypochondria. 

People  over  forty  years  of  age  are  in  danger  of  brooding 
over  themselves  and  their  imaginary  troubles  when  they  are 
not  kept  busy  at  something  more  useful.  It  is  a  bad  practice  for 
well-to-do  people  to  lie  abed  late  in  the  morning  —  to  breakfast 
in  bed,  etc.  It  is  better  for  the  health  of  both  mind  and  body 
to  be  up  and  about  —  to  be  doing  one's  part  in  the  performance 
of  the  world's  work. 

Of  course,  we  must  be  careful  not  to  confuse  and  confound  the 
early  mental  depression  which  so  frequently  accompanies  the 
beginning  of  kidney  disorders  and  certain  forms  of  heart 
disease,  with  a  purely  functional  hypochondria. 

SYMPTOMS  OF  HYPOCHONDRIA 

The  hypochondriac  is  always  busy  complaining  of  his  symp- 
toms and  otherwise  looking  after  his  health.  His  symptoms  are 
almost  as  numerous  as  those  of  the  neurasthenic  and  the  hysteric. 
He  is  troubled  with  scores  of  autosuggestions  of  symptoms  and 
diseases  which  are  partially  or  wholly  unreal.  His  brain  has 
full  power  to  originate  all  sorts  of  disease  products  such  as 


238  WORRY  AND  NERVOUSNESS 

pains,  sensations,  and  other  sorts  of  unusual  aches  and  feelings. 
These  poor  creatures  really  suffer  the  tortures  of  all  the  symp- 
toms of  their  numerous  imaginary  afflictions  just  as  truly  and 
literally  as  if  their  diseases  were  wholly  genuine. 

The  hypochondriac  will  get  up  out  of  bed  in  the  middle  of 
the  night  and  walk  the  floor  for  hours  at  a  time.  In  the  morning 
his  countenance  is  dejected  and  in  the  more  serious  forms  of 
the  disease,  the  patient  will  often  confess  to  entertaining  suicidal 
thoughts. 

TREATMENT    OF    HYPOCHONDRIA 

If  the  hypochondriac  is  not  too  old,  and  if  the  disorder  is 
not  of  too  long  standing  or  too  deeply  rooted,  much  can  often 
be  done  to  cure  and  relieve  these  sufferers.  These  patients  in 
their  anxious  efforts  to  find  a  cure,  go  from  one  doctor  to 
another,  and  are  easily  persuaded  to  take  up  any  new  remedy; 
and  in  this  way  they  contribute  much  to  the  support  of  quacks, 
fakers,  and  frauds. 

Associating  with  children  is  the  greatest  and  most  successful 
cure  for  hypochondria.  Even  horseback  riding,  driving  horses, 
and  the  care  and  training  of  animal  pets  are  all  helpful  and 
curative  diversions.  (Fig.  9.)  If  it  is  impossible  to  enjoy  the 
companionship  of  anything  alive,  then  one  might  recommend 
automobiling  as  a  possible  alternative.  The  cultivation  of  a 
garden  spot  is  a  splendid  treatment  for  mild  hypochondria  in 
old  people. 

Any  and  all  forms  of  mental  occupation  including  hobbies, 
books  on  exploration  and  adventure,  and  even  correspondence 
schools,  are  helpful  in  combating  the  blues.  These  attacks 
of  mental  depression  are  also  sometimes  cured  by  mental  shock 
such  as  sudden  business  reverses,  acute  illness,  an  unexpected 
elopement,  and  other  unlooked  for  episodes  in  the  family  or 
business  life. 

Time  and  occupation  are  the  principal  cures  for  hypochondria, 
aside  from  the  maintenance  of  a  fair  degree  of  physical  health. 
Many  of  the  great  men  of  history  have  been  more  or  less 
hypochondriac.  Yirchow,  the  great  pathologist,  was  decidedly 
hypochondriacal,  while  James  Russell  Lowell  was  so  depressed 


Fig.  9.  Animal  Pets  are  Good  for  the  Blues 


HYPOCHONDRIA  AND  MELANCHOLIA  239 

at  times  that  he  confesses  he  contemplated  suicide ;  and  yet 
these  great  men  with  many  others  achieved  success  in  life  in 
spite  of  their  periodical  depressions. 

Hypochondriacs  should  live  out  of  doors  as  much  as  possible ; 
they  should  even  sleep  out  of  doors  wherever  and  whenever 
practicable.  Mentally,  they  should  form  habits  of  doing  things 
regularly  and  systematically  and  then  forgetting  their  acts 
while  they  move  on  to  the  accomplishment  of  their  next  task. 

Many  of  these  hypochondriacs  are  in  reality  psychasthenes, 
while  their  doubts  and  fears  are  nothing  more  nor  less  than  the 
phobias  and  obsessions  of  our  former  chapters. 

SIMPLE    MELANCHOLIA 

We  have  now  come  to  the  end  of  the  simple  neuroses  and  must 
recognize  that  melancholia  is  upon  the  borderland  of  the  psy- 
choses (insanities).  While  in  the  matter  of  sadness  and  des- 
pair the  melancholic  may  much  resemble  the  hypochondriac, 
nevertheless  the  preoccupations  are  entirely  different,  "  The 
hvpochondriac  pities  himself  over  his  state  of  health,  while  the 
melancholic  regards  exterior  circumstances  with  sadness,  or 
criticizes  his  conduct  in  a  self-accusing  frame  of  mind." 

While  these  melancholic  patients  appear  to  recover  from  their 
depression,  as  a  rule,  in  most  cases,  the  improvement  is  but 
transient,  for  within  a  few  weeks  or  a  month,  they  are  again 
attacked  with  the  same  depressive  moods.  Between  these  attacks 
of  depression,  the  patient  is  often  more  or  less  exhilarated  — 
in  the  more  severe  cases  actually  maniacal.  It  is  these 
alternations  between  depression  and  exaltation  that  constitutes 
"  circular  insanity,"  otherwise  known  as  "  maniac-depressive 
insanity." 

I  am  compelled  to  recognize  that  we  have  a  type  of  mild 
melancholia  which  can  be  cured  by  proper  treatment  and  the 
regulation  of  the  patient's  environment.  And  even  the  insane 
varieties  of  melancholia  may  be  greatly  helped  by  appropriate 
treatment. 

MANIFESTATIONS  OF  MELANCHOLIA 

These  melancholic  patients  are  often  sent  to  the  neurologist 
under  the  impression  that  they  are  neurasthenics.     In  common 


24o  WORRY  AND  NERVOUSNESS 

with  hypochondriacs,  they  may  complain  of  many  physical  ills. 
While  in  good  nutrition  they  believe  they  are  losing  flesh.  They 
complain  of  internal  troubles  such  as  the  brain  rotting,  main- 
taining that  they  can  smell  the  putrefaction.  The  most  dis- 
tressing feature  of  the  disease  is  that  the  dangers  of  suicide 
are  in  no  wise  in  keeping  with  the  intensity  of  the  patient's 
disease  delusions;  that  is,  he  may  make  few  complaints  and 
yet  be  on  the  verge  of  committing  suicide. 

The  most  pathetic  of  all  are  those  cases  of  young  people, 
particularly  young  women,  who  are  stricken  with  this  inherited 
nervous  disorder.  They  suddenly  become  depressed  and  morose, 
shun  all  forms  of  social  life,  begin  to  speak  of  themselves  and 
their  work  as  a  failure,  begin  to  show  retardation  in  all  muscular 
movements  such  as  dressing,  eating,  etc.  They  begin  to  consult 
various  physicians  about  imaginary  ills  which  they  believe 
afflict  them  as  a  punishment  for  some  mistake  or  crime.  They 
gradually  lose  interest  in  everything  but  themselves,  and  even 
begin  to  hint  at  suicide. 

TREATMENT  OF   MELANCHOLIA 

Tvpical  melancholia  which  is  known  to  be  one  of  the  cycles 
of  a  "  maniac-depressive  insanity,"  should  be  treated  in  a  well- 
regulated  asylum  or  other  appropriate  institution. 

The  milder  forms  of  melancholia;  that  is,  the  neurasthenic 
or  hypochondriac  type  should  certainly  be  treated  outside  of  an 
asylum.  It  is  a  crime  to  send  such  innocent  sufferers  to  institu- 
tions for  the  mentally  deranged. 

If  the  patient  evinces  no  homicidal  or  suicidal  tendencies,  he 
may  be  safely  and  successfully  treated  at  home.  The  treatment 
consists  in  diversion  of  the  mind,  upbuilding  the  physical  health, 
eliminative  and  tonic  baths,  together  with  persistent  psycho- 
therapy. If  these  patients  are  losing  flesh,  feed  them  heavily  on 
milk  and  eggs.  Have  them  walk  three  to  five  miles  a  day  in  the 
open  air.  Keep  them  in  the  company  of  a  cheerful  companion 
or  attendant.  There  is  little  to  be  gained  from  exhorting  or 
scolding  these  patients,  and  it  usually  requires  from  three  to 
six  months  to  get  the  patient  out  of  the  attack.  Further  sug- 
gestions valuable  in  the  treatment  of  this  state,  will  be  found  in 


HYPOCHONDRIA  AXD  MELANCHOLIA  241 

later   chapters,   particularly   the   chapter   entitled   "  The    Social 
Service  Cure." 

SUMMARY   OF    THE   CHAPTER 

1.  Hypochondria  is  a  comparatively  innocent  and  harmless 
variety' of  mental  depression  in  contrast  with  melancholia  which 
runs  into  well-defined  insanity. 

2.  The  most  simple  form  of  periodical  depression  is  "  the 
blues."'  This  is  a  neurasthenic  state  dependent  upon  combined 
mental  and  physical  causes. 

3.  "  Simple  hypochondria "  lies  between  the  blues  and  the 
melancholic  hypochondria  of  the  insane,  and  is  characterized 
by  depression  and  fixed  ideas  regarding  personal  health. 

4.  The  hypochondriac,  even  though  he  has  no  disease,  makes  a 
special  business  of  having  it  anyway.  He  enormously  exag- 
gerates everything  he  feels. 

5.  Hypochondriacs  are  preoccupied  with  their  troubles,  inor- 
dinately self-centered  and  introspective  to  the  highest  degree. 

6.  Common  grief  may  be  regarded  as  a  mild  form  of  hypo- 
chondria or  melancholia.  Time  alone  is  usually  sufficient  to 
heal  the  hurt. 

7.  Bad  heredity  and  lowered  vitality  predispose  grief-stricken 
patients  to  prolonged  periods  of  depression. 

8.  Hypochondria  is  brought  on  by  poor  health,  chronic  doubt- 
ing, loss  of  position  or  fortune,  enforced  idleness  and  luxurious 
indolence. 

9.  Some  patients  suffer  from  depression  as  an  hereditary  pre- 
disposition ;  like  Hamlet,  they  are  born  doubters. 

10.  The  hypochondriac  really  suffers  from  his  imaginary  ills 
which  are  almost  as  numerous  as  those  of  the  neurasthenic  or 
hysteric. 

'11.  The  treatment  of  hypochondria  embraces  thorough-going 
medical  attention,  association  with  children  or  the  care  and 
training  of  animal  pets,  automobiling,  gardening,  etc. 

12.  Other  valuable  methods  include  the  cultivation  of  hob- 
bies, books  on  exploration,  congenial  correspondence,  outdoor 
living,  together  with  regular  mental  and  physical  habits. 

13.  Time,  occupation,  and  good  physical  health  will  cure  many 
mild  hypochondriacs. 

14.  the  melancholic  in  addition  to  worry  over  his  personal 
health  is  also  sad  over  other  and  external  circumstances.  The 
mind  is  highly  self-accusing. 

15.  In  severe  melancholia,  improvement  is  but  temporary  — 
the  interval  of  exaltation  which  is  characteristic  of  maniac- 
depressive  insanity. 


242  WORRY  AND  NERVOUSNESS 

16.  We  must  recognize  a  mild  type  of  melancholia  which  is 
curable  by  proper  treatment  and  suitable  environment. 

17.  Melancholies  are  prone  to  complain  of  things  which  are 
manifestly  untrue;  viz.,  insist  that  they  are  losing  flesh  while  the 
body  weight  remains  stationary. 

18.  Hereditary  melancholia  commonly  attacks  young  people 
between  the  ages  of  fifteen  and  twenty-five.  Many  cases  are 
amenable  to  treatment. 

19.  Typical  and  severe  melancholia  is  best  treated  in  the  asy- 
lum or  some  other  appropriate  institution. 

20.  The  milder  neurasthenic  or  hypochondriac  types  of  melan- 
cholia may  be  safely  and  successfully  treated  at  home  provided 
they  evince  no  suicidal  tendencies. 

21.  The  treatment  of  melancholia  consists  in  diverting  the 
mind,  upbuilding  the  body,  tonic  hydrotherapy,  and  appropriate 
psychotherapy. 

22.  Probably  the  most  important  factor  in  the  cure  is  to  enlist 
the  patients  in  social  service  —  set  them  at  work  doing  something 
for  someone  else. 


CHAPTER  XX 
BORDERLAND   NERVOUS   AILMENTS 

IN  ADDITION  to  the  seven  sorts  of  nervousness  we  have 
discussed  up  to  this  time,  there  remains  to  be  considered  a 
miscellaneous  group  of  nervous  disorders  which  are  partly 
hereditary,  and  in  some  instances  physical,  as  well  as  nervous, 
in  their  origin. 

CHOREA    OR    ST.    VITUS*    DANCE 

This  is  a  disorder  occurring  in  those  hereditarily  predisposed 
nervous  children,  especially  young  girls,  whose  minds  are  over- 
wrought in  comparison  with  their  muscular  activities.  It  is  a 
disease  largely  confined  to  the  adolescent  period.  It  is  a  condi- 
tion found  frequently  to  follow  rheumatism  in  children;  and, 
when  the  soil  is  ripe,  the  condition  is  immediately  caused  by 
fright,  mental  worry,  sudden  grief,  or  even  a  scolding  has  been 
known  to  bring  on  an  attack. 

The  disease  is  too  well  known  to  need  description.  It  is 
characterized  by  jerky,  involuntary  muscular  movements  and 
minor  twitching  of  the  face  and  upper  extremities.  These 
movements  are  not  indulged  in  during  sleep  or  when  the  patient's 
mind  is  fully  occupied;  on  the  other  hand  they  become  rapidly 
worse  when  the  patient  is  an  object  of  anxious  solicitude  or 
curiosity  at  either  home  or  school. 

The  treatment  consists  in  early  recognition,  mental  rest  and 
relaxation,  moderate  physical  activity,  and  such  management 
as  shall  lead  the  child  to  forget  its  ailment  and  anticipate 
recovery.  These  patients  should  be  removed  from  the  curious 
gaze  of  both  friends  and  strangers,  and  this,  in  addition  to  a 
liberal  diet  and  the  outdoor  life,  is  usually  sufficient  to  bring 
about  a  speedy  recovery.  In  fact,  the  disorder  seems  to  behave 
somewhat  after  the  manner  of  a  self-limited  malady,  and  this 

243 


244  WORRY  AXD  NERVOUSNESS 

strongly  suggests  the  idea  that  it  owes  its  origin  to  some  toxic 
or  infectious  agency. 

TICS   AND   HABIT   SPASMS 

When  any  movement  of  a  voluntary  muscle  becomes  more  or 
less  rhythmic,  regular,  and  involuntary,  it  is  regarded  as  a  "  tic."' 
The  development  of  these  motor  or  habit  spasms  serves  as  a  good 
illustration  of  the  manner  in  which  uncontrolled  feelings  and 
habits  of  sensation  may  also  have  their  origin. 

One  of  the  most  common  "  tics  "  is  the  involuntary  winking  of 
the  eye.  Other  movements  of  the  nose,  the  upper  lip  and  the 
muscles  of  expression  are  common.  We  also  observe  nodding 
tics,  talking  tics,  etc. 

The  constant  habit  when  speaking,  of  uttering  the  words 
"  don't  you  know,"  "  listen,"  or,  when  hesitating,  to  say,  "  hum," 
or  "  hem,"  are  nothing  more  than  chronic  tics.  Likewise,  the 
mannerisms  or  gestures  of  public  speakers  come  to  assume  the 
role  of  a  chronic  tic,  as  does  also  the  fussiness  of  other  people 
who  must  needs  play  with  the  pencil,  the  knife,  or  twirl  the 
mustache,  their  hair,  or  their  thumbs.  Others  chew  their  finger 
nails,  or  pick  the  nose.  By-words  and  even  blasphemy  must 
be  looked  upon  as  sort  of  vocal  tics. 

It  is  found  that  these  manifestations  of  tics  seem  to  run  in 
families ;  and  it  is  highly  probable  that  heredity  and  suggestion 
both  play  a  part  in  their  causation.  If  taken  in  time,  they  are 
practically  all  curable  by  persistent  nerve-training  methods. 
Even  the  worst  cases  may  be  greatly  benefited  or  even  cured 
if  the  patient  will  persist  in  following  the  prescribed  regime. 

STUTTERING   AND   ATAXIAS 

Stuttering  In  children  is  sometimes  lightly  regarded  because 
of  the  wide  spread  belief  that  they  will  probably  outgrow  it. 
Stuttering  or  ataxia  is  observed  in  walking,  writing,  and 
swallowing,  as  well  as  in  talking.  All  forms  of  stuttering  are 
made  worse  by  over-attention,  excitement,  and  anything  else 
that  increases  the  self-consciousness. 

The  stuttering  gait  in  walking  is  nothing  more  nor  less  than 
a  crystallized  fear.     These  patients  find  great  difficulty  in  walk- 


BORDERLAND  NERVOUS  AILMENTS  245 

ing  past  a  watching  crowd.  The  condition  is  a  nervous  fear 
and  not  a  physical  difficulty. 

Other  nervous  patients  cannot  write;  they  are  not  even  able 
to  sign  their  name  when  anyone  is  watching;  even  writer's 
cramp  must  be  regarded  as  belonging  to  this  class  rather  than 
to  that  of  the  genuine  cramps. 

We  once  had  a  patient  who  had  such  a  stuttering  of  the 
gullet  that  he  was  unable  to  eat  solid  food,  and  could  eat  noth- 
ing at  all  when  any  one  was  watching  him.  There  is  little 
doubt  that  both  suggestion  and  psychic  contagion  operate  to 
make  all  these  stutterers  and  stammerers  worse. 

Stuttering  is  prone  to  develop  at  puberty,  that  time  of  gen- 
eral awkwardness  and  bashfulness;  and  is  far  more  common  in 
men  than  in  women.  Most  stutterers  are  found  to  be  mouth 
breathers  and  many  are  afflicted  with  adenoids  and  diseased 
tonsils.  Stuttering  in  adults  is  sometimes  initiated  by  some  sud- 
den emotion,  fright,  or  accident. 

STAMMERING    CURES 

I  know  of  more  than  a  dozen  successful  systems  for  curing 
stuttering  and  stammering.  Some  of  these  systems  are  dia- 
metrically opposite,  and  yet  they  are  all  more  or  less  successful, 
which  only  goes  to  prove  that  it  is  their  power  to  take  the 
patient's  mind  off  his  talking  that  affects  the  cure,  and  not  any 
inherent  virtue  residing  in  the  system  itself. 

The  ancients  attributed  stuttering  to  tongue-tie,  the  moderns 
are  inclined  to  hold  self-consciousness  and  respiratory  disturb- 
ances to  blame.  One  system  cures  by  holding  the  tip  of  the 
tongue  against  the  palate  while  talking,  another  and  equally 
successful  method  directs  to  keep  the  tongue  firmly  on  the 
floor  of  the  mouth;  and  so  it  goes,  any  system  is  successful 
that  distracts  the  patient's  attention. 

One  of  the  most  successful  systems  is  the  singing  cure.  These 
patients  never  stutter  while  singing.  It  has  been  observed 
that  normal  speakers  talk  during  expiration,  while  the  stutterer 
usually  begins  to  speak  at  the  end  of  inspiration.  Any  system 
of  breathing  exercises  which  divert  the  mind  from  the  thought 
of  talking  are  beneficial. 


246  WORRY  AND  NERVOUSNESS 

TREMORS 

Tremors  may  be  divided  into  two  classes,  those  accompanying 
voluntary  movements  and  those  associated  with  involuntary 
movements.  The  majority  of  old  people  develop  tremors  and  are 
sometimes  greatly  alarmed  by  them,  notwithstanding  the  fact 
that  they  continue  for  many  years,  and  are  indicative  of  no 
special  disorder,  except  in  the  case  of  paralysis  agitans. 

The  voluntary  or  intentional  tremors  may  be  occasioned  by 
fright  and  by  accidents,  as  well  as  by  other  fears  and  dreads. 
Children  who  have  been  bitten  by  dogs  tremble  when  in  the 
presence  of  other  dogs.  Some  men  tremble  when  shaving  from 
the  fear  that  they  will  be  tempted  to  cut  their  throats;  others 
cannot  lift  a  cup  of  water  to  their  mouth  when  observed,  without 
exhibiting  tremors.  These  tremblings  may  even  affect  the  legs 
as  in  stage  fright. 

The  treatment  of  tremors  consists  in  upbuilding  the  physical 
health,  increasing  the  weight  (these  patients  are  usually  run 
down  in  weight),  together  with  persistent  training  of  the 
patient's  mind  along  those  difficult  lines  of  muscle  control.  The 
patient's  confidence  must  be  inspired,  favorable  suggestions 
given,  and  his  will  so  trained  that  he  is  able  to  re-master  and 
thoroughly  control  his  voluntary  muscular  movements. 

HALLUCINATIONS 

Hallucinations  are  those  vivid  inner  thoughts  of  the  mind 
which  appeal  to  the  patient  just  as  strongly  as  if  they  had  orig- 
inated in  external  sensory  impressions.  Illusions  are  a  deception 
of  the  senses;  delusions  result  from  erroneous  reasoning  and 
faulty  conclusions;  while  hallucinations  lie  midway  between 
illusions  and  delusions.  It  is  a  common  belief  that  only  the 
insane  have  hallucinations,  but  it  is  my  belief  that  at  least  one 
person  out  of  four  among  apparently  sane  and  normal  people, 
has  had  one  or  more  hallucinatory  experiences. 

Patients  who  have  had  hallucinations  are  loath  to  acknowl- 
edge their  experience  —  they  fear  they  will  be  adjudged  insane 
or  mentally  unbalanced.  The  physician  can  do  much  to  relieve 
these  worried  sufferers  by  explaining  the  probable  physical  origin 
of   most   hallucinations,    explaining    how    they    are.  due    to    a 


BORDERLAXD  NERVOUS  AILMENTS  247 

reversal  of  the  nervous  mechanism,  a  throwing  outward  of 
imaginary  images  accompanied  by  the  impression  that  these 
images  are  incoming  normal  sensations,  the  same  as  those 
resulting  from  natural  and  normal  external  sensory  excitation. 
The  doctor  can  also  help  these  patients  by  telling  them  how 
many  other  healthy  people  have  had  similar  experiences,  and 
further,  by  instructing  them  in  the  necessary  mental  discipline 
which  will  enable  the  patient  both  to  understand  and  to  over- 
come these  experiences  and  the  baseless  fears  which  they 
excite. 

Hallucinations  must  always  be  thought  of  in  connection  with 
insanity,  especially  hallucinations  of  hearing.  Many  a  so-called 
apparition  was  in  reality  a  dream-hallucination,  that  is,  the 
patient  dropped  off  to  sleep  for  a  moment,  had  his  dream,  waked 
up,  and  then  was  tricked  by  his  own  mind  into  believing  that 
what  he  dreamed  he  had  actually  seen  while  awake.  This  is 
probably  the  explanation  of  Mark  Twain's  "  disappearance " 
story,  and  many  other  similar  narratives. 

DREAMS 

From  time  immemorial,  dreams  have  disturbed  the  tranquil 
peace  of  the  human  mind.  They  begin  in  early  childhood,  aroused 
by  exciting  stories  of  Indians  and  wars,  or  perchance  by  the 
lurid  Sunday  Supplement.  We  must  not  forget  the  fact  that 
everybody  dreams  all  the  time  every  night,  but  we  only  remember 
that  portion  of  our  dream  which  is  in  the  consciousness  at  the 
moment  of  awaking. 

I  have  found  it  a  great  help  to  excitable  and  nervous  patients 
to  explain  to  them,  when  they  describe  how  they  have  "  hardly 
slept  at  all,"  "  dreamed  all  night,"  etc..  that  these  dreams  which 
they  believe  have  lasted  all  night  have  really  occurred  within  a 
few  seconds  or  at  most  a  few  moments  of  time,  at,  or  just 
preceding,  the  instant  of  waking  up. 

PHYSICAL  CAUSES  OF  DREAMS 

I  also  find  it  a  great  help  to  nervous  sufferers  to  explain  to 
them  the  probable  physical  origin  of  their  night  terrors  or 
nerve-racking   dreams.      The    most    common    dream    which    all 


248  WORRY  AND  NERVOUSNESS 

people  experience,  is  that  well-known  sensation  of  falling 
from  a  great  height  —  you  wake  up  while  falling  and 
just  before  striking  the  ground.  It  is  an  old  belief  that 
if  one  did  not  waken  before  striking  the  ground,  he 
would  be  killed  by  the  dream-fall  just  as  surely  as  if 
the  experience  were  literal.  Xow,  these  falling  dreams  are 
brought  about  by  the  following  situation :  The  patient  is  always 
sleeping  on  the  back,  and  they  nearly  always  occur  during  the 
fore  part  of  the  night  when  the  stomach  is  heavily  loaded  from 
the  evening  meal.  This  causes  such  pressure  on  the  aorta  as 
to  lessen  the  flow  of  blood  to  the  legs,  which  produces  a  tingling 
sensation  in  the  nerves  (not  so  marked  as  the  numbness  pres- 
ent when  the  foot  "  goes  to  sleep  "  ),  similar  to  that  experienced 
during  a  rapid  descent  in  an  elevator,  and  it  is  this  sensation 
in  the  legs,  and  produced  in  this  manner,  which  associates  itself 
in  the  consciousness  with  the  memory  and  imagination  data 
connected  with  the  concept  of  falling  from  a  great  height. 

Perhaps  the  next  most  universal  dream  is  that  of  being 
caught  out  in  public  with  insufficient  clothing  —  all  of  which  is 
readily  explained  when  you  awaken  from  your  embarrassment 
to  find  an  arm,  leg,  or  some  other  part  of  the  body  without  bed 
covering  and  chilled  to  the  bone. 

Another  common  and  almost  universal  dream-experience  is 
that  of  running  for  miles,  and  getting  out  of  breath  while  chased 
by  some  imaginary  enemy.  This  sort  of  a  dream  is  the  result 
of  a  real  bodily  need  of  air,  and  occurs  in  those  persons  suffer- 
ing from  adenoids  and  colds  in  the  head  which  are  sufficient 
partially  to  interfere  with  the  respiratory  function. 

It  seems  needless  in  this  day  to  add  that  dreams  are  without 
significance  other  than  has  been  noted.  All  that  has  been 
said  regarding  the  accidental  and  incidental  character  of  pre- 
monitions in  a  former  chapter,  applies  with  equal  force  to 
dreams. 

MIGRAINE 

Migraine  or  nervous  sick  headache  is  an  explosive,  par- 
oxysmal, nervous  attack,  accompanied  by  headache  (usually 
one-sided),  nausea,  vomiting,  and  other  minor  manifestations, 


BORDERLAXD  NERVOUS  AILMEXTS  249 

terminating  in  a  desire  to  sleep  which  leads  to  complete  recov- 
ery. These  attacks  are  sometimes  called  "  bilious  headaches  " 
or  bilious  spells  when  they  are  not  overly  severe.  Migraine  is 
one  of  the  most  directly  inherited  of  all  nervous  disorders.  It 
is  commonly  associated  with  indigestion,  constipation,  eye  strain, 
rheumatism,  and  a  general  neurotic  constitution.  In  many 
patients  even  a  slight  overeating  of  nitrogenous  food  is  sure 
to  precipitate  an  attack. 

While  migraine  is  not  caused  by  an  idle  and  luxurious  life, 
it  is  certainly  made  much  worse  by  such  an  aimless  existence. 
These  patients  often  submit  to  operations  for  floating  kidneys 
and  are  often  treated  and  mistreated  in  a  great  variety  of  ways 
before  they  are  able  to  find  any  great  relief.  It  should  be  re- 
membered that  migraine  is  a  disorder  all  the  while  present  in 
the  patient  and  that  these  attacks  of  sick  headache  are  merely 
its  nervous  explosions  —  the  periodical  overflow.  The  relief  or 
cure  of  migraine  (if  cured  it  can  be)  lies  in  the  re-formation 
of  the  patient's  mode  of  thinking  and  living. 

The  first  thing  for  the  migraine  patient  to  do  is  to  have  the 
eyes  thoroughly  examined  and  properly  fitted  to  glasses,  if 
required.  Xext,  let  the  nose,  throat,  and  ears  be  carefully  over- 
hauled;  then  let  the  searchlight  be  turned  on  metabolism,  con- 
stipation, and  the  general  situation  in  the  abdomen  and  pelvis. 
These  patients  must  be  taught  to  avoid  over  fatigue  —  mental, 
nervous,  and  physical.  It  is  imperative  that  such  patients 
subsist  upon  the  so-called  low  protein  diet.  The  milder  attacks 
of  migraine,  not  accompanied  by  vomiting  are  sometimes 
greatly  helped  by  eating  a  small  amount  of  food  or  by  drink- 
ing a  glass  of  hot  milk.  These  attacks  are  sometimes  aborted 
or  lessened  in  severity  by  the  timely  use  of  cathartics  or  by 
hot  colonic  flushings. 

By  thoroughly  regulating  one's  habits  of  life  —  by  normalizing 
one's  mode  of  living  —  by  the  removal  of  every  possible  and 
known  abnormal  condition  and  unhygienic  practice,  I  have 
observed  numerous  migraine  sufferers  who  have  practically 
cured  themselves  of  this  aggravating  disorder,  insomuch  that, 
notwithstanding  the  supposed  incurability  of  the  disease,  they  are 
able  to   go    from   six   months   to   a   year   without   experiencing 


250  WORRY  AND  NERVOUSNESS 

an  attack.  I  am  forced  to  add,  in  this  connection,  that  these 
patients  who  are  thus  so  successful  in  mastering  migraine,  are 
those  who,  in  addition  to  the  hygienic  regulation  of  their  lives, 
also  conquered  their  mental  modes  and  otherwise  gained  such 
control  over  their  nervous  systems  as  to  result  in  a  very  har- 
monious, peaceful,  and  happy,  habitual  frame  of  mind. 

PSEUDO-EPILEPSY 

Many  neurotic  patients  suffer  from  certain  drowsy  or  fainting 
spells  which  are  neither  true  epilepsy  nor  hysteria.  They  ex- 
perience a  brief  lapse  of  memory,  may  or  may  not  fall  uncon- 
scious, the  eyelids  grow  heavy,  and  they  have  a  rush  of  blood 
to  the  head.  These  are  the  cases  of  epilepsy  that  are  so 
marvelously  cured  by  Christian  Science,  osteopathy,  and  nu- 
merous other  forms  of  mental  healing. 

Pseudo-epilepsy  develops  on  hereditary  soil,  and  is  made  worse 
by  autosuggestion  on  the  one  hand  and  various  toxins  and 
nerve  irritants  on  the  other  hand.  An  effort  to  remove  these 
exciting  causes,  together  with  proper  psychotherapy,  is  nearly 
always  successful  in  bringing  about  a  more  or  less  complete 
cure.  On  the  other  hand,  genuine  epilepsy  is  an  incurable  dis- 
ease, except  in  those  special  forms  which  are  due  to  cranial 
accidents. 

DEFECTIVES  AND  DEGENERATES 

It  is  not  within  the  province  of  this  work  to  deal  with  those 
more  grave  and  inherited  mental  and  nervous  disorders  com- 
monly embraced  by  the  terms  feeble-mindedness,  retarded  brain 
development,  and  other  phases  and  forms  of  defective  nervous 
development. 

I  believe  it  is  a  duty  that  society  owes  itself  to  take  imme- 
diate steps  to  prevent  the  further  multiplication  of  these  mani- 
festly inferior  human  strains.  I  believe  further,  that  it  is 
equally  the  duty  of  society  to  do  everything  possible  for  the 
help  and  advancement  of  these  unfortunate  mental  defectives 
which  it  may  find  on  its  hands  at  any  given  period.  Special 
schools  must  be  established  for  the  backward  child;  and  for 
those  who  cannot  be  advanced  mentally  manual  training  must 


BORDERLAXD  XERVOUS  AILMENTS  251 

be  provided.  But  the  most  important  part  of  this  whole  problem 
is  to  devise  some  acceptable  and  efficient  method  which  will 
prevent  these  biologically  inferior,  mentally  defective,  and  so- 
cially degenerate  persons  from  reproducing  an  increased  number 
of  offspring  to  further  deteriorate  and  jeopardize  the  race 
stamina  of  future  generations;  to  still  further  fill  the  asylums, 
crowd  the  prisons,  overrun  the  schools  for  feeble-minded,  con- 
gest the  brothels,  and  further  to  tax  our  combined  charitable 
and  philanthropic  resources. 

SUMMARY   OF   THE    CHAPTER 

1.  The  borderline  nervous  ailments  are  those  partially  heredi- 
tary and  partly  physically  caused  disorders,  such  as  chorea,  tics, 
stuttering,  tremors,  ataxias,  hallucinations,  migraine  and  pseudo- 
epilepsy. 

2.  Chorea  is  a  nervous  disorder  of  young  people  characterized 
by  involuntary  twitchings.  It  is  a  self-limited  disorder,  and  it  is 
cured  by  good  hygiene  and  diverting  the  patient's  attention. 

3.  Tics  are  more  or  less  rhythmic  and  regular  movements  of  a 
voluntary  muscle  which  may  become  so  habitual  as  to  be  per- 
formed involuntarily,  such  as  winking  and  other  facial  jerkings. 

4.  Stage  mannerisms,  by-words,  twirling  the  thumbs,  and  bit- 
ing the  finger  nails,  are  all  common  and  curable  tics. 

5.  Stuttering  is  a  form  of  ataxia  observed  in  walking,  writ- 
ing, swallowing,  and  talking,  and  results  from  increased  self- 
consciousness. 

6.  Suggestion  and  psychic  contagion  operate  to  increase  stut- 
tering and  stammering.  These  patients  are  cured  by  diverting 
the  attention  and  persistent  training. 

7.  Most  young  stutterers  are  found  to  be  mouth  breathers  and 
also  have  adenoids. 

8.  Any  system  will  be  successful  in  curing  stuttering  which  is 
able  to  take  the  patient's  mind  off  his  talking.  The  singing  cures 
are  highly  successful. 

9.  Involuntary  tremors  are  found  in  the  aged,  while  voluntary 
trembling  is  occasioned  by  childish  fears  and  adult  hoodoos, 
stage  fright,  etc. 

10.  The  treatment  of  tremors  consists  in  upbuilding  the  phys- 
ical health,  together  with  persistent  and  appropriate  mental 
training. 

11.  It  is  a  mistaken  belief  that  only  the  insane  are  afflicted 
with  hallucinations.    Many  normal  people  have  these  experiences. 

12.  Many  so-called  apparitions  are  in  reality  dream-halluci- 
nations, that  is,  they  occur  in  a  moment  of  cat-napping. 


252  WORRY  AND  NERVOUSNESS 

13.  Dreams  occur  throughout  the  period  of  sleep  but  we  are 
conscious  of  only  those  caught  in  the  mind  at  the  moment  of 
awaking. 

14.  It  is  a  great  help  to  nervous  patients  to  have  the  possible 
physical  causes  of  their  dreams  fully  explained. 

15.  Migraine  is  the  most  directly  inherited  of  all  nervous  dis- 
orders. It  is  characterized  by  headache,  nausea  and  vomiting, 
and  it  is  commonly  associated  with  eye  strain,  indigestion,  and 
constipation. 

16.  The  cure  of  migraine  lies  in  re-forming  the  patient's  modes 
of  mental  and  physical  living,  eliminating  all  causes  which  are 
removable. 

17.  It  is  imperative  that  migraine  sufferers  live  upon  the  so- 
called  low  protein  diet. 

18.  Pseudo-epilepsy  is  a  curable  nervous  disorder  caused  by 
neurotic  heredity,  autosuggestion,  and  autointoxication. 

19.  Society  has  a  double  duty  to  perform  with  reference  to 
its  defectives  and  degenerates.  First,  to  give  these  unfortunates 
every  opportunity  for  improvement ;  and  second,  to  provide 
methods  to  prevent  the  reproduction  of  their  kind. 


PART  II 

TREATMENT     OF     THE    NERVOUS 

STATES 


PART  II 
TREATMENT  OF  THE  NERVOUS 

STATES 


CHAPTER  XXI 
THE  GENERAL  HYGIENE  OF  THE  NERVOUS  SYSTEM 

THE  management  of  the  human  nervous  system  is  probably 
the  most  important  branch  of  hygiene.  This  importance 
is  due  to  the  embryological  and  anatomical  fact  that  the  nervous 
system  inherited  from  one's  ancestors  and  which  is  present  in 
the  infant  body  at  birth,  is  the  same  identical  nervous  mechanism 
which  must  be  carried  throughout  life;  that  is,  the  individual 
cells  of  the  nervous  system  retain  their  identity  throughout  a 
life  time,  and  this  explains  why  the  behavior  of  the  nerve 
centers  is  only  changed  by  persistent  efforts  in  reeducation 
carried  on  for  a  sufficient  length  of  time  to  produce  new  habits 
of  nervous  behavior. 

GENERAL    PRINCIPLES 

It  is  my  belief  that  in  the  future  the  physician's  consulting 
office  is  destined  to  become  a  psychotherapeutic  laboratory  in 
which  the  human  nervous  system  will  be  scientifically  studied, 
diagnosed,  and  prescribed  for.  The  day  in  which  the  doctor's 
office  is  to  be  merely  an  adjunct  to  the  chemist's  shop  is  about 
over.  The  physician  of  the  future  is  destined  to  become  a  men- 
tal minister,  dispensing  courage,  hope,  confidence,  and  stoicism 
to  his  patients,  all  of  whom  are  more  or  less  disordered  in 
nerves  and  discouraged  in  mind.  These  nervous  people  must 
be  taught  how  to  think  logically  and  reason  calmly,  and  in 
view  of  the  present  organization  of  society  and  its  agencies  of 

255 


256  WORRY  AXD  NERVOUSNESS 

physical,  mental,  and  spiritual  relief,  I  cannot  see  how  this 
work  can  be  effectively  carried  out  except  by  the  medical 
profession. 

Another  principle  we  must  recognize  is  that  whenever  public, 
or  more  properly,  social  hygiene,  is  brought  into  conflict  with 
personal  hygiene,  the  public,  social,  or  national  hygiene  must 
be  given  precedence.  The  welfare  of  the  whole  people  is  never 
to  be  sacrificed  for  the  supposed  welfare  of  an  individual ;  in 
other  words,  the  hygiene  of  the  family — for  the  family  is  the 
social  unit  of  the  nation — is  to  stand  out  pre-eminently  as  the 
all-important  necessity  in  the  development  of  the  mental  and 
physical  well-being  of  civilized  society.  Nerve  stamina  is  the 
one  national  resource  which  needs  to  be  conserved. 

Partridge  well  summarizes  the  general  principles  of  nervous 
hygiene  as  follows: 

1.  In  every  nervous  individual,  the  habit  of  too  great  intensity  of 
mental  activity  must  be  cured  or  controlled.  For  tension  is  one  of 
the  universal  faults  of  the  nervous  life.  In  all  cases  it  will  be  found 
that  something  remains  to  be  learned  in  this  regard.  To  this  end 
emotions  that  goad  on  the  mind  to  over-activity  must  be  attacked. 
Interests  must  perhaps  be  readjusted,  ideals  modified,  and  wishes 
abandoned.  Here,  too,  is  the  problem  of  rest,  of  relaxation,  both  in 
its  mental  and  physical  aspects. 

2.  Invariably  there  is  some  degree  or  form  of  excessive  individu- 
ation. Here  enters  the  problem  of  the  adjustment  of  the  individual 
to  society.  The  questions  must  be  asked  how  the  work  can  be  made 
more  social;  how  the  relation  of  self-interest  and  work  as  social  can 
be  made  more  normal ;  how  emotional  causes  of  strain  and  isolation 
can  be  eliminated.  Interests  must  be  trained  to  this  end.  The  prob- 
lem of  the  recreational  life  arises. 

3.  Always  there  is  some  degree  of  mental  disorder.  Experience  is 
never  organized  with  ideal  completeness.  There  is  mental  confusion. 
To  overcome  this  is  essentially  a  work  of  education.  It  is  prevent- 
ive.   The  mind  must  be  trained  by  being  organized. 

4.  The  fourth  general  conception  for  the  control  of  the  nervous 
life  is  that  the  organism,  mind  and  body,  is  an  energy-  system.  It  can 
be  exhausted,  restored,  controlled,  both  by  mental  and  by  physical 
means.  As  a  machine  the  body  has  its  definite  laws,  its  optimum 
mode  of  working  to  produce  the  most  power  from  its  supply  of 
energy.     This  optimum  mode  of  living  must  be  called  in  to  attain 


HYGIEXE  OF  THE  NERVOUS  SYSTEM  257 

this  ideal.    A  regime  of  treating  the  body  and  mind  must  be  adopted, 
not  for  a  week  or  a  month,  but  for  a  lifetime. 

HEREDITY  AND   PROPHYLAXIS 

Space  forbids  our  entering  into  a  lengthy  consideration  of 
heredity  in  relation  to  the  human  nervous  system  and  its  de- 
rangements. We  will  have  to  be  content  at  this  time  with  the 
statement  of  the  fact  that  nervous  disturbances  and  diseases  are 
more  largely  hereditary  than  other  sorts  of  human  disorders; 
in  fact,  as  shown  in  earlier  chapters,  there  is  an  hereditary  ele- 
ment in  almost  every  typical  case  of  nervous  derangement. 

The  proper  place,  of  course,  to  begin  the  prophylaxis  of  the 
nervous  system  is  with  one's  ancestors ;  but  since  the  choosing 
of  our  ancestors  is  quite  beyond  the  range  of  possibilities,  we 
are  forced  to  begin  the  consideration  of  the  prophylaxis  of  the 
nervous  system  at  a  time  which  corresponds  with  its  earliest 
appearance  in  the  embryological  metamorphosis  of  pre-natal 
life;  in  other  words,  the  thing  of  first  importance  in  the  attain- 
ment of  the  healthy  nervous  system  in  the  child  is  to  provide  the 
expectant  mother  with  an  abundance  of  good  food,  pure  water, 
and  to  surround  her  with  a  wholesome,  sanitary,  and  happy 
environment. 

While  we  have  emphasized  in  a  former  chapter  the  fact  that 
scares  and  frights  on  the  part  of  the  mother  have  absolutely 
nothing  to  do  with  the  "  marking  "  of  children,  it  is  our  duty 
at  this  time  equally  to  emphasize  the  fact  that  the  general 
physical  health,  particularly  the  nervous  state  of  the  expectant 
mother,  may  become  so  disordered  and  deranged  as  greatly 
to  affect  her  general  health  and  physical  well-being,  and  in 
this  way,  she  is  rendered  utterly  incompetent  properly  to  nour- 
ish and  upbuild  the  physique  and  nervous  system  of  the  unborn 
child.  And  it  is  in  this  very  manner  that  the  physical  condition 
of  the  mother  may  react  to  the  detriment  of  the  nervous  devel- 
opment of  the  child. 

POSITIVE  AND  NEGATIVE   HYGIENE 

Personal  hygiene  consists  of  two  phases:  first,  positive,  those 
rules  or  laws  of  life  defining  what  we  should  do;  and  second, 


258  WORRY  AND  NERVOUSNESS 

negative,  those  rules  or  laws  of  life  defining  what  we  should 
not  do.  The  positive  hygiene  of  the  nervous  system  dictates 
that  we  should  think,  work,  rest,  and  sleep  evenly  and  regularly ; 
that  we  should  cultivate  the  social  instincts  of  the  race  and 
occupy  the  mind  with  thoughts  that  are  wholesome,  uplifting, 
healthful,  and  beautiful.  The  negative  hygiene  of  the  nervous 
system  warns  us  away  from  the  shoals  and  rocks  of  intemper- 
ance, overwork,  inordinate  mental  application,  and  those  per- 
sonal or  social  pursuits  which  are  vicious  and  debilitating, 
admonishing  us  to  shun  fear,  anxiety,  worry,  and  depression. 

The  secret  of  success  in  the  management  of  the  nervous 
system  is  centered  principally  in  avoiding  all  those  causes  which 
make  for  nerve  over-taxation,  irritation  and  subsequent  break- 
down. We  are  in  possession  of  no  sort  of  medical  magic  which 
will  enable  us  to  remove  the  results  of  a  nervous  hereditary 
legacy;  but  it  is  entirely  possible  to  take  a  human  nervous  sys- 
tem, very  weak  from  heredity,  and  so  to  guard,  mould,  and 
train  this  faulty  nervous  mechanism  in  its  youthful  unfolding 
as  to  develop  a  vast  array  of  counterbalancing  possibilities 
which  are  latent  within  the  individual,  and  thus  to  create  a 
set  of  opposing  neurological  forces  which  will  be  able  almost, 
if  not  altogether,  to  overpower  and  overcome  the  manifestly 
inherited  and  undesirable  nervous  weaknesses. 

If  fond  parents  would  only  overcome  all  prejudice,  rise  above 
their  slavery  to  conventionalities  and  fashions,  and  so  raise 
and  train  their  little  boys  and  girls  as  to  develop  their  weak 
points,  repress  deformities,  and  encourage  symmetrical  growth 
and  development  of  the  nervous  system,  much  could  be  done 
to  lessen  the  growth  of  that  great  and  constantly  increasing 
army  of  neurasthenics,  hysterics,  and  other  neurotic  weaklings. 

The  keynote  of  nervous  prophylaxis  is  this:  do  not  make 
vourselves  sick  by  artificial  means;  that  is,  by  worry  on  the 
mental  side,  and  by  various  poisonings  on  the  physical  side. 
Abstain  from  all  poisonous  and  pernicious  sorts  of  self-gratifi- 
cation, train  the  nervous  system  to  lead  an  orderly,  systematic, 
temperate,  and  controlled  existence.  To  sum  up:  avoid  fear 
and  worry  and  all  their  psychic  accompaniments  on  the  mental 
side;  while  you  avoid  alcohol,  tobacco,  and  other  narcotic  and 


HYGIEXE  OF  THE  NERVOUS  SYSTEM          259 

stimulating  drugs,  including  tea  and  coffee,  on  the  physical  side. 
Regarding  this  positive  mental  discipline,  Dr.  Dubois  says : 

Let  us  always  maintain  this  smiling  courage;  it  should  not  be  a 
fierce  and  bitter  stoicism,  but  an  easy  valor  like  that  of  the  gentlemen 
of  olden  times,  who  so  dexterously  wielded  the  rapier.  We  must  put 
on  this  warlike  frame  of  mind  in  the  morning;  we  must  make  our 
moral  toilet  and  re-clad  ourselves  in  our  coat  of  mail.  We  can  then 
say  to  ourselves :  "  Whatever  the  day  may  bring  of  physical  fatigue, 
intellectual  work  or  mental  emotion,  I  am  ready;  my  powers  are 
sufficient  and  there  is  a  margin  to  spare."  Another  simile  often 
comes  to  my  mind,  when  I  feel  weakness  beginning  in  the  face  of  the 
task  to  be  performed :  "  Forward !  Let  the  band  of  the  regiment 
play,  and  the  step  will  become  light-hearted." 

CHILDHOOD    NEUROLOGY 

The  hygiene  of  the  infant's  nervous  system  begins  with  the 
first  day  of  life  and  consists  in  keeping  it  in  a  reasonably  quiet, 
darkened  room  for  the  first  few  days.  As  the  baby  grows  older, 
do  not  allow  the  fond  friends  to  bounce  it  on  the  knee,  throw 
it  overhead  or  toss  it  up  in  the  air.  These  hair-raising  experi- 
ences are  exceedingly  deleterious  in  case  the  child  should  have 
a  sensitive  or  delicately  balanced  nervous  mechanism.  Do  not 
fuss  over  the  babies.  Just  let  them  grow  up,  take  good  care  of 
them,  give  them  plenty  of  food,  water,  and  sleep. 

As  the  children  grow  older,  avoid  all  causes  of  depression, 
worry,  or  fright.  Especially  avoid  threats  of  the  "  boogy  man," 
the  "  bad  man,"  and  all  the  "  boo  dark "  sort  of  stuff  that 
frightens  the  young  mind  by  day  and  terrorizes  it  in  dreams  by 
night.  Be  careful  fully  to  explain  even  the  stories  of  adventure, 
the  Indian  stories,  etc.,  so  as  not  to  leave  too  vivid  an  impres- 
sion on  the  young  mind,  and  thus  train  away  from  these  "ter- 
ror-dreams" of  the  night  season.  The  young  mind  is  very 
susceptible  to  these  impressions  of  fear,  and  tyrannical  terror  is 
generated  within  these  little  souls  that  sometimes  lasts  through- 
out a  lifetime.  We  not  infrequently  find  ourselves  as  physicians 
struggling  with  these  children  as  grown  up  men  and  women, 
trying  to  overcome  their  ever-present  fears  —  those  deep-seated 
apprehensions  which  have  become  almost  a  part  of  their  mental 


260  WORRY  AND  NERVOUSNESS 

and    nervous    nature  —  and    which    had    their    origin    in    the 
"  scares  "  and  "  frights  "  of  early  childhood. 

Keep  the  little  ones  away  from  funerals,  tragic  scenes,  and 
all  other  depressing  experiences,  which  so  indelibly  impress 
their  plastic  minds  and  so  persistently  linger  in  the  soul  to  har- 
row and  torment  them  in  the  years  which  are  to  follow. 

EARLY  SELF-CONTROL 

While  the  child's  nervous  system  is  unfolding  and  develop- 
ing, let  him  grow  up  in  a  natural,  playful,  and  healthful  manner, 
giving  attention  to  but  a  single  factor,  and  that  the  ele- 
ment of  discipline  and  self-control.  It  is  my  firm  belief  that  the 
child  which  is  not  taught  self-control  before  it  is  six  or  eight 
years  of  age,  seldom,  if  ever,  acquires  a  satisfactory  self-con- 
trol in  after  life;  at  least,  if  he  does,  it  is  by  sheer  dint  of 
persistent  and  long  continued  effort,  all  of  which  would  have 
become  second  nature  to  him  had  he  been  trained  into  this 
fundamental  requisite  of  moral  happiness  and  mental  health, 
when  he  was  a  baby.  What  can  you  expect  of  an  infant  in 
after  life  who  is  taken  up  and  coddled,  rocked,  and  danced  about 
every  time  it  opens  its  mouth  and  emits  a  healthy  holler? 

The  hygiene  of  the  child  when  it  reaches  the  school  age  is 
a  great  subject  in  itself,  and  would  require  a  volume  adequately 
to  cover  it.  In  this  chapter  we  can  only  call  attention  to  the 
great  importance  of  medical  inspection  in  the  public  schools  — 
a  system  designed  early  to  detect  the  presence  of  adenoids  in 
the  child  and  thus  avoid  the  subsequent  effects  of  these  perni- 
cious growths  on  the  nervous  system.  Medical  inspection  would 
early  detect  the  child  of  retarded  mentality,  or  of  nervous 
tendencies  toward  chorea,  or  St.  Vitus'  dance;  would  early  de- 
tect the  presence  of  eye  difficulties  and  direct  the  fitting  of 
proper  glasses  and  thus  avoid  the  frequent  nervous  effects 
of  early  and  severe  eye  strain.  The  lighting  and  ventilation  of 
the  school  room,  the  arrangement  of  the  seats  for  the  preven- 
tion of  spinal  curvature,  recreation  periods,  exercise  —  all  of 
these  and  many  other  related  phases  of  hygiene  are,  directly 
or  indirectly,  factors  in  the  hygiene  of  the  nervous  system  in 
childhood. 


HYGIENE  OF  THE  XERVOUS  SYSTEM  261 

REST    AND    RELAXATION 

Before  the  adolescent  period  of  life,  growing  boys  and  girls, 
as  the  result  of  their  playful  activities,  are  so  tired  out  at  night 
that  they  require  little  urging  to  take  proper  rest  and  they  do 
not  have  to  be  taught  how  to  relax.  When  asleep  they  are  per- 
fectly limp,  entirely  relaxed;  but  with  the  arrival  of  that  period 
in  life  in  which  play  begins  to  be  decreased  and  work  begins 
to  intrude  itself  upon  our  mind  and  energies,  there  sometimes 
comes  the  necessity  of  relearning  the  art  of  relaxation  —  learn- 
ing all  over  again  how  to  let  go  —  how  really  to  rest  while  sit- 
ting, standing,  or  even  when  reclining. 

The  nervous  system  is  a  difficult  creature  to  educate,  hard  to 
train,  but  when  once  it  learns  a  certain  method  of  procedure 
or  acquires  a  definite  habit  of  behavior,  it  is  equally  difficult 
to  unlearn  its  acquired  habits  and  re-learn  new  and  more  desir- 
able ones.  The  boy  and  the  girl,  if  normal,  naturally  and 
instinctively  know  how  to  play  and  how  to  rest  and  relax;  but 
we  start  in,  sometimes  altogether  too  early  (especially  in  the 
case  of  neurotic  and  nervously  weak  children),  to  train  and 
teach  them  how  to  work,  and  so  sometimes  by  eighteen  or  twenty 
years  of  age  we  have  so  well  trained  them  out  of  play  and  into 
work  that  they  have  quite  lost  the  power  to  relax  and  rest. 
The  nervous  system  has  acquired  the  propensity  of  everlast- 
ing activity.  Even  sleep  flees,  and  when  the  body  is  laid  at 
rest,  although  imperfectly  relaxed,  the  mind  keeps  pace,  and 
hour  after  hour  of  the  night  season  is  spent  in  tossing  about  on 
the  bed,  while  a  maddening  rush,  a  veritable  deluge,  of  dis- 
ordered and  disconnected  thoughts  chase  themselves  through  the 
brain. 

All  of  this  might  have  been  prevented  by  a  simple,  temper- 
ate, and  sensible  mode  of  living  —  of  both  working  and  resting. 
Thus  the  art  of  relaxation,  so  well  known  in  youth,  would  not 
have  been  lost  in  early  manhood  and  womanhood;  but  the  en- 
couraging fact  should  be  recorded  right  here,  that  it  can  always 
be  regained.  There  is  none  so  nervous,  no  victim  of  high 
tension,  but  who  can  re-learn  once  more  and  again  re-acquire 
the  blessings  of  peaceful  relaxation,  calm  rest,  and  refreshing 


262  WORRY  AND  NERVOUSNESS 

sleep.    These  are  all  lost  arts  which  can  be  wooed  and  won  back 
again  by  proper  habits  of  thinking  and  living. 

SOCIAL  INTERCOURSE 

Long  ago  it  was  recorded  in  the  Good  Book  that  it  is  "  not 
good  for  man  to  be  alone,"  and  whatever  the  significance  of 
this  statement  as  regards  the  domestic  life  of  men  and  women, 
it  is  an  absolute  fact,  well  known  to  the  neurologist,  that  it  is 
not  good  for  the  nervous  health  of  any  individual  to  be  alone; 
that  is,  it  is  not  good  for  neurotic  people  to  eat  alone,  or  work 
alone,  or  walk  alone,  or  to  live  by  themselves.  Social  inter- 
course in  the  shop,  at  the  office,  in  the  home,  is  almost  absolutely 
necessary  for  the  cure  of  many  of  these  nervously  deranged  and 
mentally  disorganized  individuals.  I  remember  well  the  case 
of  a  young  lady,  twenty-three  years  of  age,  a  stenographer, 
who,  after  all  other  efforts  had  failed  to  cure  her  nervous 
difficulties,  was  entirely  cured  within  a  year's  time  by  finding 
a  congenial  position  in  an  office  where  she  also  found  another 
young  lady  of  similar  tastes,  whom  she  secured  for  a  room- 
mate, and  this  social  life  (for  these  two  girls  became  constant 
companions,  bosom  friends,  veritable  chums)  supplied  the  addi- 
tional aid,  the  absence  of  which  rendered  all  other  treatment 
futile. 

I  have  seen  this  thing  over  and  over,  again  and  again:  the 
taking  up  of  tennis,  the  joining  of  a  club,  getting  interested  in 
politics,  preaching  socialism,  becoming  interested  in  athletics, 
or  getting  married  —  if  happily  it  turned  out  well  —  I  say, 
I  have  seen  all  these  things  result  in  the  cure  of  neurotics  and 
neuroses,  even  after  years  of  fruitless  treatment  at  the  hands 
of  the  most  skillful  physicians.  Crowds  are  always  helpful  in 
the  cure  of  neurasthenia. 

I  enjoin  my  nervous  patients  that  they  must  never  be  alone. 
When  alone  they  only  think  of  themselves,  they  become  inordi- 
nately introspective  and  their  thoughts  are  all  wrapped  in  self- 
pity  and  self-sympathy.  I  have  long  since  learned  better  than 
to  take  the  neurasthenic  out  of  the  busy  office  and  away  from 
the  rush  of  a  great  city  and  send  him  alone  out  into  the  coun- 
try or  off  on  some  farm  to  rusticate  and  recuperate.    They  in- 


HYGIENE  OF  THE  NERVOUS  SYSTEM         263 

variably  get  worse.  This  country  life  is  ideal  for  nervous 
disorders,  but  it  must  always  be  so  arranged  as  to  provide  so- 
cial life,  companionship,  and  fellowship,  for  it  is  doubly  true 
of  the  neurotic  individual  that  it  is  "  not  good  for  man  to  be 
alone." 

ORGANIZATION  AND  TRAINING 

The  economical  and  hygienic  management  and  administra- 
tion of  one's  nervous  energies  imperatively  demand  the  thor- 
ough organization  of  one's  business,  household  duties,  and  all 
other  phases  of  mental  and  physical  activity,  along  such  lines  as 
will  provide  for  a  practical  and  systematic  control  of  one's  daily 
life  so  as  to  facilitate  the  accomplishment  of  a  maximum  amount 
of  work  with  a  minimum  of  mental  effort  and  expenditure  of 
nervous  energy.  It  is  enough  to  give  one  nervous  prostration 
to  gaze  upon  the  desks  of  some  business  men,  to  look  into  the 
system  and  bookkeeping  of  some  professional  men,  and  to  ex- 
amine carefully  the  routine  of  household  administration  in  the 
case  of  numerous  nervous  housewives. 

This  utter  lack  of  system  is  responsible  for  increasing  the 
nervous  friction  from  fifty  to  one  hundred  per  cent  every  day. 
Many  neurotics  who  are  wearing  themselves  out  and  who  are 
always  on  the  "  verge  of  breaking  down,"  if  they  would  only 
learn  how  to  organize  their  work  and  systematize  their  efforts, 
could  do  twice  what  they  are  now  doing  and  have  a  colossal 
picnic  while  engaged  in  the  task.  By  perfecting  my  system.  I 
find  I  can  work  harder  and  harder  with  less  and  less  nervous 
strain.  I  find  that  I  am  having  real  fun  and  enjoying  the 
highest  degree  of  health  imaginable,  doing  what  some  people 
choose  to  call  two  or  three  men's  work  and  yet  I  have  abun- 
dance of  time  for  recreation  and  numerous  hobbies,  even  more 
time  than  I  discover  some  men  have  who  are  wearing  them- 
selves out  doing  what  would  grudgingly  be  regarded  as  even 
one  man's  task;  and  it  must  be  remembered  that  this  system 
and  organization  also  pertains  to  one's  brain  and  mental  activ- 
ities. It  involves  concentration  of  the  mind  and  a  more  or 
less  complete  control  and  direction  of  the  mental  powers,  and 
does  not  consist  wholly  in  the  organization  of  one's  business 


264  WORRY  AXD  NERVOUSNESS 

and  work  by  means  of  card  indexes  and  other  modern  methods 
in  office  systematizing  and  business  control. 

FE    MARGINS 

Every  man  and  every  woman  must  sooner  or  later  learn  their 
own  individual  margin  of  safety  in  matters  of  nervous  tension 
and  over-exertion.  Some  individuals  are  born  neurologically 
bankrupt  and  hence  have  but  very  meager  margins  of  nervous 
safety.     The  slightest  nen  rdraft   in  mental   strain   or 

over-work  is  sufficient  to  prostrate  them.    On  the  other  hand,  we 
discover  those  individuals  who  are  born  neurologically  rich  — 
neuroli  gic  millionaires.     During  their  life  time  they  arc  able  to 
overwork  and  overindulge,  and  the  ner  tem,  with 

its    vast    margin    of    safety,  to    stand    the    -train,    while 

-cores  of  their   friends  an  vs  of  tl 

set  or  their  business   associates,   who   were   born   with   smaller 
nervous  capital  and  margin  n  to  wreck  and  ruin  in  their 

efforts  to  follow  the  pace  set.     An  I  ".ion  goes  to  show 

that  many  of  the  offspring  of  il    spendthrifts 

are  born  into  the  world  more  or  les  isly  handicapped  as 

the  result  of  this  parental  extravagance. 

Particularly  then,  for  you,  the  reader,  the  most  important 
thing  is  to  determine  personally  your  own  margin  of  safety 
and  then  say  to  yourself,  with  religious  positiveness,  "Thus 
far  shalt  thou  go,  and  no  farther.'' 

NATURAL  SLEEP 

Xext  to  the  power  of  relaxation  while  awake,  the  ability  to 
enjoy  sound  sleep  is  the  greatest  requirement  in  the  hygiene  of 
the  nervous  system.  The  strongest  nervous  system  will  sooner 
or  later  be  undermined  by  inability  to  sleep  properly,  although 
the  influence  of  light  sleep  or  lack  of  sleep  on  the  nerv 
greatly  exaggerated  in  the  popular  mind.  It  is  possible  for 
nervous  people  to  go  for  days  and  even  weeks  without  sleep, 
without  being  seriously  affected  by  this  experience.  The  no- 
tion that  one  is  liable  to  lose  one's  mind  and  go  insane  as  a 
result  of  a  few  days'  or  weeks'  insomnia  is  altogether  erroneous. 


HYGIEXE  OF  THE  NERVOUS  SYSTEM         265 

Forel  say? : 

To  supply  nourishment  to  the  nervous  system  is  not  sufficient  in 
itself ;  for  a  continuous  exertion  of  the  neurones  finally  reduces  them 
to  a  state  of  exhaustion  which  may  be  so  marked  that  it  can  be 
shown  under  the  microscope  in  the  ganglion  cells.  (Hodge.)  Hence 
time  and  rest  must  be  given  to  build  them  up  again  through  the  blood. 
Simply  sitting  or  lying  down  gives  opportunity  for  this  to  the  spinal 
cord  and  ganglia;  but  the  brain,  the  organ  of  thought,  requires  sleep. 
In  other  words,  the  cerebral  neurones  which  have  been  working 
together  must  be  relieved  from  their  concentrated  activity  of  atten- 
tion. The  importance  of  sleep  as  rest  for  the  brain  has  been  much 
misunderstood.  The  more  we  work  mentally  the  more  sleep  we 
require.  But  strenuous  muscular  exertion  in  what  we  call  "  bodily  " 
activities,  such  as  walking,  riding,  digging  or  factory  work,  means 
work  for  the  brain,  too,  and  also  requires  sleep. 

But  when  it  comes  to  the  treatment  and  cure  of  the  different 
nervous  states,  sleep  is  our  great  ally.  It  is  necessary  carefully 
to  canvass  the  patient's  experience  to  ascertain  the  causes  of 
insomnia  and  then  faithfully  work  for  their  removal.  Diet, 
constipation,  circulatory  disorders,  fears,  worries,  muscular 
tension,  too  much  or  too  little  physical  exercise,  ventilation  of 
the  bedroom,  water  drinking,  disturbing  night  noises,  these  and 
a  host  of  other  factors,  must  all  be  inquired  into  and  remedied. 

DIVERSITY  OF   OCCUPATION 

A  lot  of  nervous  people  are  never  going  to  get  .well  unless 
they  either  learn  to  like  the  job  they  have  or  else  trade  it  off 
and  get  one  that  they  can  like.  Satisfaction  with  one's  work, 
the  ability  truthfully  to  say,  "  I  like  my  job  "  and  say  it  with 
a  zest,  is  one  of  the  secrets  of  success  in  the  treatment  and 
cure  of  nervousness.  I  have  sometimes  found  it  desirable  to 
advise  a  complete  change  in  vocation.  The  confining,  grinding, 
taxing,  long-hour  occupations  are  all  contraindicated  in  neuras- 
thenia and  its  allied  nervous  conditions.  On  the  other  hand,  it 
makes  no  difference  how  ideal  the  sanitary,  health,  and  other 
surroundings  of  a  position  may  be,  if  it  is  one  of  solitary 
employment,  it  must  be  rejected;  as  we  have  already  stated  neu- 
rasthenics must  not  live  by  themselves,  much  less  work  by 
themselves. 


266  WORRY  AND  NERVOUSNESS 

Regarding  the  value  of  well-directed  work,  a  well-known 
authority  has  said: 

If  any  one  exercises  only  one  given  activity,  such  as  a  definite 
muscular  movement,  the  muscle  in  question  undoubtedly  becomes 
very  strong  and  so  does  the  corresponding  path  of  neurones.  But 
then  everything  else  can  be  stunted.  The  same  is  true  of  a  person 
who  spends  his  whole  life  riding  to  death  some  one  circle  of  ideas 
or  feeling  or  habit.  In  this  way  people  who  are  not  exactly  crazy 
can  become  monomaniacs;  like  the  chess-player  whose  whole  life  is 
filled  with  chess,  the  mother  whose  love  for  an  only  child  so  out- 
grows all  other  feelings  that  it  degenerates  into  an  idolatry  that  is 
highly  injurious  and  leads  to  all  sorts  of  follies,  or  the  man  who  has 
turned  all  his  energies  to  a  petty  invention  that  is  going  to  make  him 
rich,  and  wears  himself  out,  often  for  nothing.  All  these  one-sided 
exercises  involve  a  stunting  of  the  other  brain  activities,  and  unless 
they  be  exercised  in  the  useful  arts,  they  seldom  lead  to  anything 
profitable.  A  good  hygiene  of  the  nervous  system  thus  includes  an 
harmonious  exercise  of  all  parts  of  the  nervous  life,  of  concrete 
sense-perception,  of  all  muscular  actions,  of  intellect,  of  feeling,  of 
will,  and  also  of  imagination,  the  combining  tendency  which  opens 
new  pathways  for  the  brain's  action.  By  means  of  a  proper  sys- 
tematic training  in  every  sphere  one  becomes  not  only  happy,  but  free 
and  rich ;  rich  not  always  in  money,  but  in  capacity  for  work,  and 
free  from  the  slavery  of  superfluous  and  injurious  needs;  happy  in 
the  joy  of  difficulties  overcome  as  well  as  in  the  feeling  of  health  and 
strength,  of  increased  efficiency,  independence,  and  adaptability. 

NATURE   CULTURE 

There  is  something  peculiarly  uplifting  and  healing  in  get- 
ting near  to  nature's  heart.  It  is  good  for  the  nervous  system 
to  send  a  young  couple  out  studying  botany  or  zoology ;  or  to 
find  the  neurasthenic  woman  working  in  the  garden  with  her 
husband  or  with  a  congenial  nurse.  All  of  the  modern  fads 
embraced  within  the  term  of  "  return  to  nature  "  are  of  value 
in  the  management  of  these  nervous  disorders,  provided  the  so- 
cial element  is  not  omitted.  By  no  means,  however,  should 
hygiene  despise  art  and  science  and  their  products,  but,  on 
the  contrary,  it  should  make  clear  to  itself  which  of  them  are 
favorable  to  a  healthy  normal  development  of  our  civilized 
races  and  which  are  harmful. 


HYGIEXE  OF  THE  NERVOUS  SYSTEM  267 

The  true  art  of  a  sound  nerve  hygiene  thus  consists  in  fitting  cul- 
ture properly  to  '  Nature  ' ;  i.  e.,  in  eliminating  as  far  as  possible  from 
culture  all  injurious  and  unnecessary  excrescences  which  run  con- 
trary to  the  modified  conditions  of  human  life. 

This  is  the  advantage  that  comes  from  taking  up  fads; 
whether  it  be  tango  on  the  one  hand,  with  its  physical  action  and 
exertion,  or  ethical  culture,  psychology,  or  Greek  literature  on 
the  other.  The  reading  of  the  book  alone  at  home  would  never 
produce  the  brilliant  results  that  are  to  be  observed  as  the 
result  of  pursuing  these  "culture  studies"  in  small  classes; 
and  all  this  is  simply  due  to  the  fact  that  it  is  the  social 
association,  the  class  spirit,  the  pursuit  of  some  goal  in  asso- 
ciation with  and  in  the  company  of  other  human  beings  —  that 
is  the  secret  of  the  cure. 

Christian  Science  and  kindred  cults  do  a  great  deal  toward 
managing  their  "  cures "  by  their  weekly  associations,  their 
testimony  meetings,  for  in  this  way  the  patient  once  cured  finds 
himself  enrolled  in  the  ranks  of  an  earnest  company  who 
stand  for  certain  ideas  and  ideals,  and  he  will  hardly  dare  to 
desert  the  flag  of  his  new  found  religion  for  a  sufficient  length 
of  time  even  to  recognize  the  pain  of  a  bona  fide  headache. 
And  so  the  patients  of  the  various  "  liquor  cures  "  add  much 
to  the  permanency  of  their  cures  by  associating  together  in 
clubs,  meeting  together  to  recount  their  experiences,  and  such 
a  feeling  of  human  loyalty  and  patriotism  comes  to  pervade 
their  minds  that  they  would  not  think  of  getting  drunk  and  thus 
deserting  the  noble  ranks  to  which  they  belong.  And  all  of 
this  is  psychologically  sound,  and  we  must  further  recognize 
that  it  pervades  even  the  religious  circles,  and  that  many  a 
moral  conflict  has  been  won  and  a  spiritual  victory  achieved 
because  of  the  strength  acquired  through  the  social  meetings 
of  the  various  religious  denominations.  And  again  the  Good 
Book  was  psychologically  sound  when  it  admonished  the  faith- 
ful, "  neglect  not  the  assembling  of  yourselves  together,"  and, 
"  speak  often  one  to  another." 

RECREATION  VS.  PLEASURE  SEEKING 

Recreation  is  one  of  the  fundamentals  in  the  cure  of  nerv- 


268  WORRY  AXD  NERVOUSNESS 

ousness.  On  the  other  hand,  I  am  coming  more  and  more  to 
believe  that  mere  pleasure  seeking  —  the  pleasure  seeking  of 
the  selfish  and  sordid  sort  that  is  so  fashionable  today  —  is 
coming  to  be  one  of  the  great  causes  of  our  modern  restless- 
ness and  nervousness.  The  highest  form  of  recreation  from  the 
standpoint  of  curing  the  nervous  patient  is  that  sort  of  recrea- 
tion which  embodies  the  outdoor  life,  more  or  less  physical 
activity  in  the  midst  of  a  wholesome  environment,  and  at  the 
same  time  affords  the  opportunity  of  social  intercourse ;  and 
still  further,  in  order  to  be  ideal,  this  social  intercourse  should 
be  of  the  altruistic  sort,  that  is,  the  neurasthenic  should  be, 
in  the  midst  of  all  these  ideal  surroundings,  doing  something 
for  somebody  else.  In  this  way  his  mind  would  be  effectively 
and  ideally  taken  off  himself  and  placed  upon  another  human 
being.  This  is  the  ideal  method  of  mental  substitution,  which 
is  so  effective  in  the  management  and  cure  of  nervous  dis- 
orders. 

Theater  going  as  a  rule  is  not  good  for  the  graver  nervous 
disorders.  The  ventilation  is  usually  bad,  the  patients  have 
to  sit  comparatively  quiet  in  a  seat  for  several  hours,  they 
sometimes  mentally  associate  or  connect  themselves  very  vividly 
with  some  character  upon  the  stage,  the  association  subse- 
quently being  depressing  to  the  mind  and  discouraging  to  them. 
Theater  going  does  not  afford  opportunity  for  free  and  helpful 
conversation  and  that  intermingling  with  one's  fellows;  and 
it  is  for  this  reason  that  tennis,  athletics,  automobiling  with 
the  family  or  with  a  group  of  friends,  cross  country  walks, 
strolls  in  the  parks,  or  boating,  with  other  forms  of  outdoor 
exercise  and  association,  are  found  to  be  more  helpful  and  ef- 
fective as  curative  diversions  in  all  these  different  sorts  of 
nervous  disorders. 

The  neurasthenic  will  seldom  get  much  help  out  of  solitary 
globe-trotting,  or  other  forms  of  diversions  and  amusements 
which  are  wholly  selfish  and  self-centered.  Altruism  as  a  men- 
tal state  and  philanthropy  as  a  mode  of  life  represent  the  ideal 
attitude  of  the  nervous  patient  who  wrould  speedily  achieve  a 
cure. 

Forel  has  well  said : 


HYGIEXE  OF  THE  XERVOUS  SYSTEM  269 

Moreover  we  must  banish  pleasure-seeking  (but  not  pleasure 
itself)  from  our  lives.  Every  pleasure  cultivated  for  its  own  sake 
leads  to  ennui  and  disgust  and  injures  the  nervous  health.  Every 
healthy  enjoyment  must  be  earned  by  an  harmonious  mode  of  life. 
It  is  a  pleasure  to  sleep,  even  on  a  hard  bench,  if  you  are  tired,  or 
to  eat  crude  dishes  if  you  are  hungry.  To  drink  pure  water  is  a 
healthy  enjoyment  if  you  have  a  natural  thirst,  and  it  does  not  injure 
one  like  the  satisfaction  of  the  artificial  thirst  for  alcohol  that  results 
from  poisoning. 

NERVOUS    HYGIENE    OF    WOMEN 

A  whole  volume  could  be  written  on  the  special  hygiene  of 
the  feminine  nervous  system,  but  on  the  whole  it  does  not  dif- 
fer markedly  from  that  which  we  are  here  considering.  There 
are  certain  factors  to  which  attention  should  be  called  and 
which  we  have  noted  in  former  chapters,  respecting  the  appro- 
priate teaching  of  the  young  girl  who  is  just  blossoming  into 
womanhood  —  the  hygiene  of  adolescence.  Again,  the  hygiene 
of  the  nervous  system  becomes  specially  pertinent  in  connec- 
tion with  the  menstruation  period,  and  it  is  at  such  times  that 
the  nervously  inclined,  high-strung  woman  should  obtain  a  suf- 
ficient amount  of  physical  rest  and  nerve  relaxation;  and  it 
should  be  possible  to  do  this  without  falling  into  that  sort  of 
semi-invalidism  which  such  women  so  often  and  so  unfortu- 
nately acquire,  at  least  when  they  are  not  forced  to  go  about 
their  regular  pursuits  by  the  necessity  of  earning  their  own 
livelihood. 

We  have  already  noted  the  special  hygiene  and  care  that 
are  so  imperatively  required,  and  so  seldom  adequately  practiced, 
during  pregnancy ;  and  then  again  there  is  a  special  hygiene 
of  the  nervous  system  to  be  thought  of  following  childbirth. 
Some  of  our  most  deplorable  cases  of  insanity  are  those  which 
follow  upon  the  stress  and  strain  and  toxemia  of  pregnancy  and 
childbirth.  We  believe  that  many  of  these  cases  could  be  pre- 
vented if  proper  care  was  taken  of  the  over-wrought  nervous 
system  during  this  critical  period. 

The  only  other  special  period  of  life  in  which  the  woman  may 
be  regarded  as  requiring  special  hygienic  care  is  that  of  meno- 
pause, commonly  known  as  the  "  change  of  life."     It  is  true 


270 


WORRY  AND  NERVOUSNESS 


that  certain  nervously  predisposed  women,  as  it  were,  "  go 
to  pieces  "  at  this  time,  but  it  is  the  author's  opinion  that  this 
is  largely  a  matter  of  suggestion.  They  remember  other  women 
who  "  went  to  pieces "  at  this  time,  or  perhaps  they  had  a 
mother  or  aunt  who  almost  lost  her  mind  during  "  the  change," 
and  they  have  grown  up  with  this  fool  notion  so  deeply  rooted 
in  their  minds  that  when  they  in  turn  arrive  at  this  time  of 
life,  they  begin  to  over-exaggerate  and  misinterpret  every  little 
feeling  and  sensation  to  such  an  extent  that  they  soon  find 
themselves  wrought  up  to  such  a  pitch  of  anxiety  and  fear 
that  they  are  forced  to  recognize  that  something  is  really  going 
wrong  with  themselves. 

In  other  words,  it  is  my  belief  that  from  half  to  three-quarters 
of  all  the  troubles  associated  with  the  change  of  life,  outside 
of  a  few  minor  disturbances,  such  as  hot  flashes,  etc.,  are  en- 
tirely in  the  mind  of  the  patient,  and  in  most  cases  could  have 
been  prevented,  and  can  be  stopped  by  proper  mental  direc- 
tion, self-control,  and  an  adequate  understanding  as  to  just 
what  is  taking  place  in  the  human  system  at  such  times. 

THE   UNMARRIED  AND   CHILDLESS 

The  nerve  hygiene  of  single  people,  childless  married  peo- 
ple, old  maids,  bachelors,  widows,  and  widowers,  deserves  spe- 
cial attention.  As  a  class  these  people  are  given  to  a  great 
deal  of  thinking  about  themselves,  while  they  are  usually  quite 
without  a  definite  aim  and  purpose  in  life.  There  is  a  great 
tendency  for  this  class  to  become  selfish,  self-centered,  while 
the  tender  emotions  of  natural  affection  and  love  are  so  little 
exercised  that  the  unselfish  social  instincts  become  stunted. 
There  is  a  great  tendency  to  develop  a  peculiar  temperament 
and  an  eccentric  disposition. 

When  a  woman  has  neither  a  husband  nor  a  child  to  love,  she 
is  altogether  likely  to  develop  an  inordinate  fondness  for  angora 
cats  or  lap  poodles.  Likewise,  when  men  do  not  have  their 
better  natures  drawn  out  and  their  unselfish  instincts  devel- 
oped by  the  responsibilities  and  care  of  a  family,  they  become, 
as  a  rule,  more  and  more  self-centered  in  all  their  thoughts 
and  plans. 


HYGIEXE  OF  THE  NERVOUS  SYSTEM  271 

It  is  absolutely  necessary  in  the  interests  of  nervous  hygiene 
that  all  persons  without  family  and  all  married  persons  with- 
out children  should  develop  some  specialized  hobby  in  art, 
science,  literature,  or  philanthropy,  and  assiduously  devote 
themselves  to  their  choice  —  literally  to  bestow  their  heart's  af- 
fection upon  their  work,  in  the  absence  of  husband,  wife  or 
children.  A  failure  to  have  some  definite  humanitarian  object 
upon  which  to  bestow  one's  affections,  upon  which  to  lavish 
one's  labor,  will  be  attended  by  the  penalty  of  developing  the 
hermit's  disposition ;  unhappiness  and  disease  can  be  the  only 
result  of  such  a  solitary  existence.  If  intelligent  men  and 
women  will  not  marry  and  have  children,  then  nature  exacts, 
as  the  price  of  their  continued  health  and  happiness,  that  they 
raise  up  and  nourish  worthy  objects  of  science,  art,  literature, 
and  sociology. 

THE    HYGIENE    OF    OLD    AGE 

It  is  a  pitiful  spectacle  to  observe  the  old  man  who  has  worked 
so  hard  throughout  life,  in  order  to  earn  the  right  to  rest  in 
his  old  age,  trying  to  enjoy  idleness  and  rest  while  engaged 
in  a  round  of  efforts  to  achieve  selfish  enjoyment.  Such  aged 
business  men  and  others  who  have  led  an  active  life  sooner  or 
later  discover  that  they  cannot  gracefully  rest  when  they  grow 
old.  It  is  only  the  lazy  idler  who  can  enjoy  aimless  pleasure- 
seeking  in  old  age.  The  nervous  hygiene  of  the  aged,  while  it 
requires  that  the  pace  should  be  slackened  and  the  work  de- 
creased, nevertheless  demands  that  the  old  man  or  the  old 
woman  shall  work  on  and  on  until  the  last  breath  is  drawn. 
There  can  be  no  happiness  in  store  for  the  men  or  women  who 
retire  from  business  or  from  life's  duties  unless  they  find  other 
and  equally  absorbing  lines  of  work  or  endeavor  with  which  to 
engage  their  minds  and  occupy  their  energies. 

The  pessimistic  old  gentleman  and  the  quarrelsome  old  lady, 
as  a  rule,  are  those  who  have  tried  to  stop  work  in  their  old 
age.  They  are  endeavoring  to  sit  down  in  peace  and  quiet  and 
enjoy  life,  but  they  are  rewarded  only  with  peevish  discontent; 
they  become  a  bore  to  themselves  and  a  nuisance  to  their 
loved  ones;  they  blame  their  children  and  grandchildren  and 


272 


WORRY  AND  NERVOUSNESS 


other  relatives  for  their  misery,  and  all  of  this  could  have  been 
prevented  had  their  powers  been  kept  employed  in  useful  work 
to  the  last.  The  most  beautiful  picture  of  the' eventide  of  life 
is  the  old  man  with  the  sound  brain,  who  works  steadily  on 
until  the  end.  radiating  optimism,  sunshine,  and  wisdom  to  all 
about  him.  proving  himself  the  valued  counselor  of  his  younger 
associates  and  effectually  demonstrating  that  the  evening  of  life 
is  the  most  beautiful  period  of  existence  when  one's  energies  are 
employed  in  an  appropriate  maimer  and  when  one's  unselfish 
interests  are  kept  in  action  to  the  very  end. 


NERVOUS    HYGIENE   OF   THE    NEUROTIC 

The  nervous  hygiene  of  the  neurotic,  the  nervously  defective, 
etc.,  will  be  considered  throughout  the  remaining  chapters  of 
this  work.  In  the  case  of  sadly  defective  and  neurotic  chil- 
dren, the  advantages  of  country  training  homes  should  be  ex- 
tended to  the  city  schools  where  such  children  are  in  attendance. 

The  more  highly  defective  members  of  society,  who  border 
on  the  criminal  classes,  vagrants,  incurable  alcoholics,  etc., 
should  be  forcibly  detained  on  special  farms,  with  suitable 
work  shops  and  agricultural  pursuits,  and  work  should  be 
made  compulsory. 

Special  sanitariums  need  to  be  established  to  be  devoted  to 
the  psychological  and  physiological  training  of  men  and  women 
who  possess  a  defective  nervous  system  or  deficient  mind  con- 
trol. In  these  institutions,  farm  work  and  other  trades  should 
be  taught  and  thus  work  should  be  combined  with  suitable  so- 
cial opportunities,  while  the  entire  bend  and  trend  of  these 
organizations  should  be  highly  spiritual  and  largely  altruistic. 
Last  but  not  least,  more  thorough  study  and  earnest  attention 
must  be  devoted  to  the  practical  questions  of  improving  the 
nervous  quality  of  human  stock  we  are  producing  —  scientific 
eugenics. 

SUMMARY   OF    THE   CHAPTER 

1.  The  physician  of  the  future  will  undoubtedly  pay  much 
more  attention  to  the  hygiene  of  the  nervous  system. 

2.  Whenever  personal  and  social  hygiene  conflict,  social  hy- 
giene should  take  precedence. 


HYGIEXE  OF  THE  NERVOUS  SYSTEM  273 

3.  The  general  principles  of  nervous  hygiene  must  deal  with 
over-tension,  excessive  individuation,  mental  confusion,  and  the 
economics  or  nervous  energy. 

4.  While  the  prophylaxis  of  the  nervous  system  is  largely 
ancestral,  and  but  slightly  pre-natal,  nevertheless  much  good  can 
be  accomplished  by  early  discipline. 

5.  Nervous  hygiene  is  divided  into  two  phases,  positive  —  those 
things  which  we  should  do;  negative  —  those  things  which  we 
should  not  do. 

6.  The  keynote  of  nervous  hygiene  is  to  refrain  from  over- 
work, over-worry,  and  self-poisoning. 

7.  It  is  sometimes  necessary  to  assume  a  warlike  mental  atti- 
tude, and  move  forward  in  spite  of  emotional  obstacles. 

8.  The  nervous  system  of  the  infant  requires  even  care  and 
should  not  be  startled,  jolted,  or  otherwise  over  excited. 

9.  Children  should  not  be  threatened,  frightened,  depressed, 
worried  or  otherwise  have  their  emotions  over-stimulated. 

10.  The  child  that  is  not  taught  self-discipline  before  six  or 
eight  seldom  acquires  self-control  gracefully. 

11.  School  hygiene  embraces  medical  inspection,  ventilation, 
lighting,  seating,  exercise,  and  adaptation  of  work  to  mental 
strength  and  nervous  vigor. 

12.  Nervous  relaxation  is  inherent  in  the  youth,  but  it  is  often 
lost  as  a  result  of  vocational  training  and  industrial  tension. 

13.  The  lost  arts  of  rest  and  relaxation  can  always  be  regained 
by  proper  habits  of  thinking  and  living. 

14.  If  "  it  is  not  good  for  man  to  be  alone,"  it  is  positively 
dangerous  for  neurasthenics  to  live  an  isolated  or  solitary  life. 

15.  Outdoor  living,  social  intercourse,  and  altruistic  pursuits 
are  the  essentials  of  nervous  hygiene. 

16.  Loneliness  is  the  bane  of  the  neurotic.  Crowds  are  always 
helpful  in  the  cure  of  neurasthenia. 

17.  The  economy  of  nerve  energy  requires  the  thorough  or- 
ganization of  business,  home,  and  one's  daily  work.  Lack  of 
system  increases  nerve  friction. 

18.  Lack  of  system  and  not  overwork  is  what  produces  the 
nervous  breakdown  of  so  many  people. 

19.  Determine  the  nervous  margin  of  safety  for  your  own 
organism,  and  then  command :  "  Thus  far  shalt  thou  go  and  no 
farther." 

20.  Xext  to  relaxation,  sleep  is  the  great  requisite  of  nervous 
hygiene.     Sleep  is  the  great  ally  of  neuro-therapeutics. 

21.  Vocational  contentment,  environmental  satisfaction,  and 
diversity  of  mental  occupation,  are  the  essentials  of  nervous 
diversity  of  mental  occupation,  are  the  essentials  of 
nervous  hygiene.  Rest  is  the  keystone  to  the  arch  of  mental 
healing. 


274  WORRY  AND  NERVOUSNESS 

22.  Mental  monotony  predisposes  to  monomania,  while  single- 
ness of  purpose  may  destroy  the  mental  balance. 

2$.  There  is  a  peculiar  uplifting  and  healing  in  getting  near 
to  nature's  heart.    Nature  study  is  good  for  "  nerves." 

24.  Fashionable  fads  are  useful  only  when  pursued  in  classes. 
Association  is  the  secret  of  their  success. 

25.  Cured  patients  when  associated  in  clubs,  churches,  etc., 
develop  a  therapeutic  patriotism  which  is  invaluable  to  perma- 
nency. 

26.  Recreation  is  a  fundamental  of  nervous  hygiene,  while 
selfish  pleasure  seeking  is  of  but  little  value. 

27.  The  special  nervous  hygiene  of  women  has  to  do  with 
adolescence,  maternity,  and  menopause. 

28.  The  unmarried'  and  childless  have  need  to  bestow  their 
affections  upon  some  adopted  child  of  art,  literature,  or  philan- 
thropy. . 

29.  The  hygiene  of  old  age  requires  that  the  mind  should  be 
kept  appropriately  active  unto  the  very  end. 

30.  The  hygiene  of  the  neurotic  can  be  efficiently  carried  out 
only  in  special  schools,  institutions,  and  sanitariums. 


CHAPTER  XXII 
MODERN  PSYCHOTHERAPY  — MENTAL  MEDICINE 

PSYCHOTHERAPY,  or  "  mind  cure,"  has  been  utilized  by 
medical  and  religious  practitioners  in  the  treatment  of 
disease  and  for  comforting  the  afflicted  for  thousands  of  years. 
It  is  true  that  very  often  those  who  were  most  successful  in 
this  practice  of  mental  medicine  were  entirely  ignorant  of  the 
laws  of  mind  and  matter  which  were  being  thus  utilized.  Psy- 
chotherapy is  not  a  new  remedial  science  — "  mind  cure  "  is 
not  a  new  healing  art.  The  twentieth  century  merely  marks 
the  era  in  which  mental  medicine  emerged  from  the  empiric 
darkness  of  the  medieval  ages  into  the  daylight  of  rational 
inquiry  and  scientific  investigation. 

THE    EVOLUTION    OF   PSYCHOTHERAPY 

At  the  close  of  the  nineteenth  century,  mind  cure  was  still 
largely  practiced  by  clairvoyants,  quacks,  and  the  enthusiasts 
of  newly  discovered  religions,  which  were  largely  promulgated 
by  means  of  this  so-called  divine  healing  adjunct;  but  with 
the  dawn  of  the  twentieth  century,  as  a  result  of  the  accumulat- 
ing and  apparently  remarkable  cures  which  had  been  wrought 
by  the  increasingly  numerous  psychic  cults,  the  attention  of  the 
medical  profession  was  arrested  for  a  sufficient  length  of  time 
to  enable  the  doctors  to  begin  a  serious  investigation  into  the 
subjects  of  mental  medicine,  mind  cure,  and  so-called  divine 
healing. 

And  so  the  day  has  arrived  when  the  physician  recognizes 
mental  influence  as  both  the  cause  and  the  cure  of  numerous 
functional,  nervous,  circulatory,  and  digestive  disorders.  It 
is  no  longer  necessary  for  a  patient  actually  to  become  men- 
tally deranged  in  order  to  command  the  serious  attention  of 
scientific  medical  men. 

275 


276  WORRY  AND  NERVOUSNESS 

The  moment  the  medical  profession  seriously  turns  its  at- 
tention to  the  subject  of  mental  medicine,  that  very  moment  the 
remarkable  and  sometimes  apparently  miraculous  mind  cure 
stunts  of  the  psychic  cult  promulgators  begin  to  lose  their 
exclusively  religious  significance.  For  with  the  banishment 
of  religious  superstition  and  psychological  ignorance,  the  ma- 
jority of  these  remarkable  mind  cures  are  found  orderly  to 
take  their  place  in  line  with  those  cures  of  disease  which  are 
wrought  in  compliance  with  the  laws  of  mind  and  matter;  and 
so,  today,  we  are  in  the  midst  of  that  fanatical  and  unsettled 
transition  period  which  attends  all  methods  of  healing  as  they 
pass  from  the  empiric  stage  of  superstition  into  the  hands  of 
scientifically  trained  practitioners.  It  is  characteristic  of  all 
schools  of  medicine  and  methods  of  healing  that  in  their  early 
years  unwarranted  and  extravagant  claims  were  made  in  be- 
half of  their   curative   powers. 

REACTION    TO    MATERIALISM 

Humanity  seems  to  revise  its  beliefs  and  progress  in  its 
philosophy  only  in  cycles  of  time,  measured  by  the  life  of  one 
or  more  generations.  Accordingly,  following  the  centuries  of 
superstition,  the  latter  part  of  the  nineteenth  century  witnessed 
the  development  and  widespread  acceptance  of  scientific  and 
rationalistic  materialism.  This  reaction  to  the  superstition  of 
past  ages  was  carried  too  far  and  was,  in  turn,  during  the  open- 
ing of  the  present  century,  followed  by  a  new  reaction  of  spirit- 
ism, as  exemplified  in  the  phenomenal  growth  and  development 
of  the  numerous  present  day  psychic  cults  and  healing  "  isms." 
The  need  of  the  hour  is  for  men  and  women  who  will  pain- 
stakingly examine  and  calmly  investigate  the  facts  and  phe- 
nomena of  mental  healing,  and  thus  be  in  a  position  intelligently 
to  lend  their  influence  to  steadying  and  staying  the  attitude  of 
the  public  mind  on  these  matters  sufficiently  to  enable  us  to 
arrive  at  sane  and  fundamental  conclusions. 

SCIENTIFIC    MIND    CURE 

It  is  not  strange  that  when  modern  psychotherapy  began  first 
to  be  widely  preached  under  the  guise  of  "  religious  healing," 


MODERX  PSYCHOTHERAPY  277 

that  thousands  of  depressed,  despondent,  and  grief-stricken 
souls,  bound  in  their  prisons  of  fear  and  shackled  with  sorrow 
and  worry,  should  have  found  peace  of  mind  and  cure  for  their 
functional  nervous  ailments  in  these  new  psycho-religious  teach- 
ings. Many  of  these  souls  had  honestly  tried  both  orthodox 
religion  and  orthodox  medicine,  and  we  should  be  charitable  in 
criticizing  them  for  taking  up  with  teachings  which  at  least 
gave  them  some  temporary  peace  of  mind  and  transient  health 
of  body. 

Mind  cure  is  now  passing  as  a  religion,  a  cult,  or  a  creed. 
It  is  rapidly  assuming  that  scientific  role  in  which  it  is  known 
as  psychotherapy,  and  is  being  practiced  in  a  sane  and  sym- 
pathetic manner  by  regular  physicians,  or  by  experts  who  have 
had  special  training  in  psychology  in  addition  to  their  medical 
experience. 

WHAT    15    PSYCHOTHERAPY? 

Psychotherapy  is  a  term  we  now  use  to  include  all  methods 
of  mental  training  and  mental  healing  designed  to  relieve  those 
victims  of  functional  nervous  disturbances  and  defective  mental 
control,  commonly  diagnosed  as  neurasthenics,  hysterics,  hypo- 
chondriacs, etc.,  and  includes  all  scientific  methods  of  mental 
medicine  such  as  suggestion,  diversion,  persuasion,  reeduca- 
tion, psychanalysis,  etc. 

In  the  chapter  on  "  fastidious  suffering  "  attention  was  called 
to  the  fact  that  not  all  our  sensations  and  pains  are  real ;  that 
is,  they  are  not  actually  physical  in  their  origin,  and  it  is  to 
the  relief  and  cure  of  this  great  group  of  disorganized,  disso- 
ciated, turbulent,  uncontrolled,  and  haphazard  sort  of  mental 
and  nervous  behavior  which,  in  one  form  or  another,  so  pa- 
thetically afflicts  such  large  numbers  of  people,  that  modern 
methods  of  psychotherapy  must  be  directed  as  the  chief  and 
most  effective   curative   agent. 

Regarding  the  manner  and  method  of  exciting  the  activity 
of  the  sensory  mechanism  of  the  body,  Dubois  says : 

If  we  look  at  the  various  stimuli  which  determine  the  reactions  of 
our  different  organs,  and  which  in  fact  make  life,  we  shall  find  two 
classes: 


278  WORRY  AXD  NERVOUSNESS 

i.  Physical  stimuli,  acting  upon  our  five  senses  and  determining 
reactions  directly. 

2.  Psychic  stimuli,  in  which,  even  when  of  sensorial  origin,  the 
reaction  is  only  brought  about  by  mental  representation,  i.  e.,  follows 
upon  thoughts  and  ideas. 

Allowing  that  in  final  analysis  these  two  orders  of  stimuli  may  be 
reducible  to  material  elements,  it  is  none  the  less  true  that  there  are 
notable  differences  between  them. 

The  physical  stimuli,  both  physiological  and  artificial,  are  in  their 
essence  more  or  less  known ;  they  are  measurable  and  always  iden- 
tical in  their  action.  These  are  the  reactions  that  are  studied  in 
physiology.  Let  us  note  that  these  reactions  are  all  possible  in 
natural  or  induced  sleep;  the  experiments  of  vivisection  are  most 
usually  performed  in  the  state  of  narcosis.  These  stimuli  are  also 
interchangeable  and  we  can  equally  excite  the  motor  and  sensory 
nerves  and  those  of  the  special  senses  by  their  natural  stimulus  or  by 
mechanical  irritants,  such  as  a  blow,  heat,  or  electricity. 

For  a  more  complete  consideration  of  the  psychology  of  asso- 
ciated memory,  complex  formation,  and  dissociation  of  ideas, 
which  are  involved  in  the  practice  of  modern  psychotherapy, 
the  reader  is  referred  to  the  author's  previous  work,  The  Physi- 
ology of  Faith  and  Fear,  or  the  Mind  in  Health  and  Disease, 
where  these  matters  are  more  fully  discussed  than  will  be 
possible  in  this  work. 

PSYCHIC  SEED  SOWING 

The  human  mind  with  its  vast  and  wonderful  realms  of  idea- 
association  and  imagination  is  a  wonderful  soil  which  the  ex- 
pert psycho-agriculturist  may  ingeniously  cultivate,  and  in 
which  he  may  intelligently  sow  the  seeds  of  faith  and  courage 
and  confidence.  Human  beings  are  highly  suggestive;  in  fact, 
the  human  baby  is  the  most  highly  imitative  creature  in  the 
world,  and  the  utilization  of  this  tendency  to  absorb  ideas  and 
imitate  the  actions  of  other  people  constitutes  the  basis  upon 
which  the  art  of  suggestion  —  the  science  of  suggestive  ther- 
apeutics—  is  based. 

The  majority  of  neurotics  are  highly  suggestive,  and  this 
fact  accounts  for  the  easy  manner  in  which  they  reason  them- 
selves into  all  sorts  of  trouble.     Upon  the  other  hand,  under 


MODERX  PSYCHOTHERAPY  279 

the  care  of  the  psychotherapist,  this  suggestive  tendency  is 
swung  around  into  helpful  and  beneficial  lines,  and  is  strikingly 
utilized  in  bringing  about  the  cure  of  the  patient. 

As  will  be  more  fully  shown  in  later  chapters,  this  method 
of  treating  mental  disorders  may  take  the  form  of  autosug- 
gestion—  suggestions  given  by  the  patient  to  himself;  or  thera- 
peutic suggestion,  as  in  the  case  of  where  suggestions  are 
directed  to  the  patient's  mind  by  his  friends  or  his  physician. 
We  also  have  environmental  suggestion,  as  patients  literally 
absorb,  quite  unconsciously  of  course,  ideas  from  their  asso- 
ciates and  surroundings. 

The  suggestion  may  often  be  hidden,  even  as  it  is  in  the  case 
of  the  regular  practice  of  medicine,  for  it  is  undoubtedly  true 
that  the  more  faith  the  patient  has  in  the  drugs  he  takes,  the 
more  good  he  gets  from  them.  We  have  to  recognize  the 
psychic  element  even  in  the  use  of  electricity,  baths,  and  mas- 
sage, and,  of  course,  it  becomes  the  exclusive  element  operating 
in  the  various  cults  of  mental  healing,  including  Christian 
Science. 

Suggestion-education  is  what  led  the  common  people  into  their 
disastrous  patent-medicine  habits.     They  soon  discovered  that 
the  doctor  had  a  drug  for  every  symptom,   for  every  dis 
They   observed    that    the    final    result    of    his    numerous    well- 
charged-for-visits  were  usually  a  row  of  empty  medicine  bot- 
tles sitting  on  the  table;  and  so  instinctively,  seeking  to  obvi- 
ate   this   expensive   middleman,   they   went   direct   to   the 
store  for  their  medicines,  and,  after  reading  the  literature  and 
the  rosy  testimonials  accompanying  their  patent  remedies, 
came  to  acquire  great  faith  in  the  new  medicine,  took  it,  and 
usually  got  well. 

PSYCHIC    SUBSTITUTION 

It  is  absolutely  out  of  the  question  in  the  treatment  of  men- 
tal and  nervous  disorders  to  hope  for  success  in  the  task  of 
immediately  getting  a  settled  idea  out  of  the  mind.  In  the 
early  treatment  of  these  nervous  patients  it  is  necessary  to 
practice  the  art  of  psychic  substitution,  that  is,  faith  ideas  must 
be  substituted  for  fear  notions,  health  confidence  must  be  put 


28o  WORRY  AXD  NERVOUSNESS 

in  the  place  of  disease  worry,  good  ideas  must  be  suggested  and 
cultivated  so  as  to  overcome  and  eliminate  erroneous  mental 
notions;  and  it  is  in  this  way.  very  often,  long  before  the  real 
causes  of  the  disturbance  are  permanently  removed,  we  are  able 
to  bring  about  great  relief  to  the  patient  —  greatly  to  improve 
his  symptoms  and  relieve  his  mental  torture;  in  fact,  in  many 
cases  which  are  at  the  bottom  incurable,  great  good  can  be 
accomplished  by  relieving  the  obsessions,  crystallized  fears,  and 
otherwise  setting  in  order  the  confused  methods  of  thinking. 

This  method  is  carried  out  not  only  along  the  lines  of  idea- 
substitution,  but  also  in  the  field  of  physical  activities  —  motor 
substitution.  Patients  are  directed  in  new  and  different  lines 
oi"  phvsical  employment  with  a  view  of  causing  the  mind  to 
follow  in  the  same  paths,  and  thus  divert  it  from  the  old  chan- 
nels of  worry  and  self-contemplation. 

It  is  possible  to  carry  out  this  principle  of  substitution  even 
in  the  realms  of  emotion  and  affection,  and  as  will  be  noted 
more  fully  in  a  later  chapter,  remarkable  cures  are  wrought  by 
leading  self-centered  individuals  to  fall  in  love  with  someone, 
or  with  art.  or  literature,  or  a  fad,  and  thus  to  transplant  their 
affections  from  self  to  the  external  world. 

It  is  not  at  all  such  a  difficult  task  to  change  a  patient's  mind 
when  he  is  at  all  susceptible  to  reason  and  when  he  has  con- 
fidence in  the  physician ;  and  while  it  is  true,  during  the  earlier 
part  of  the  treatment,  their  old  ideas  will  come  galloping  back 
into  the  mind  as  soon  as  the  patient  has  left  the  office;  never- 
theless, faithful  and  intelligent  work  will  ere  long  begin  to 
show  results,  and  the  patient  will  begin  to  present  a  different 
mental  attitude,  one  which  shows  that  the  mental  habits  are 
steadily  changing  and  improving.  Perseverance  is  the  watch- 
word of  modern  psychotherapy. 

SYMPATHY   AXD  PERSUASIOX 

It  is  not  uncommon  to  see  a  very  sick  patient  wonderfully 
improved  immediately  after  the  physician's  visit,  even  before 
a  sufficient  time  has  elapsed  to  allow  any  medicine  or  treatment 
to  produce  this  effect.  This  immediate  improvement  is  the 
result  of  the  sympathy  shown  by  the  physician  to  the  patient, 


MODERN  PSYCHOTHERAPY  281 

and  of  the  confidence  exercised  by  the  patient  in  the  physician 
—  in  his  skill  and  ability  to  cure. 

And  so  the  ideal  physician  is  not  merely  a  prescriber  of 
medicine,  but  he  is  a  minister  to  the  mental  disorders  of  the 
patient,  yes,  he  is  even  a  minister  to  the  souls  of  the  sick.  I 
am  beginning  to  think  that  as  the  science  of  medicine  progresses 
and  our  methods  of  healing  become  more  and  more  precise, 
the  future  "  art  of  medicine  "  lies  in  this  great  and  formerly 
neglected  domain  of  mental  ministry  to  the  minds  of  mankind. 

The  art  of  persuasion  is  one  of  the  most  valuable  assets  of 
the  physician  who  seeks  to  help  those  patients  suffering  from 
"  nerves."  Gentle  firmness,  positive  precision,  together  with 
personal  sympathy,  seldom  fail  to  win  the  confidence,  respect, 
and  loyalty  of  the  patient  to  such  an  extent  as  to  generate  a 
sufficient  amount  of  therapeutic  patriotism  as  will  lead  him  to 
persevere  in  his  treatment  to  a  successful  termination. 

The  pleasant  smile  and  the  hearty  handshake  extended  to  the 
patient  as  he  enters  the  office,  coupled  with  the  farewell  assur- 
ance of  success  as  he  leaves,  does  the  patient  just  as  much 
good  as  the  instruction  and  suggestions  imparted  during  the 
course  of  the  consultation.  The  successful  physician,  at  least 
in  these  matters,  accomplishes  far  more  good  by  his  words 
than  by  his  remedies. 

REEDUCATION    OF    THE   WILL 

It  is  the  reeducation  of  the  will  with  which  we  are  most 
concerned  in  modern  psychotherapy.  Suggestion  represents  the 
general  method  of  our  treatment,  while  the  reeducation  of  the 
will  is  the  goal  toward  which  we  are  steadily  aiming,  to  enable 
the  patient  to  become  the  master  of  himself,  to  reinstate  the 
will  in  its  place  of  sovereign  ruler  over  mind  and  body. 

The  author  has  had  the  greatest  success  in  treating  these 
patients  by  the  direct  and  honest  conversational  method,  first 
recommended  by  Prince  and  Dubois.  This  consists  in  system- 
atically and  judiciously  laying  the  real  facts  before  the  patient, 
and  while  physical  treatment,  such  as  baths,  etc.,  is  admin- 
istered to  alleviate  his  symptoms,  the  real  dependence  to  effect 
a  cure  is  placed  upon  this  regime  of  reeducation. 


282  WORRY  AXD  NERVOUSNESS 

And  so  it  is  possible,  without  resorting  to  any  sort  of  arti- 
fice—  without  telling  the  patient  any  therapeutic  lies,  or  with- 
out practicing  any  other  sort  or  form  of  deception,  to  keep  a 
nervous  sufferer's  mind  intelligently  focused  upon  the  truth — ■ 
upon  the  fact  —  that  he  is  surely  going  to  get  well.  It  is  the 
reiteration  and  repeated  inculcation  of  this  truth  into  and  upon 
the  patient's  mind  until  it  becomes  a  settled  conviction  in  Ids 
soul  that  constitutes  the  very  basis  of  cure. 

It  is  sometimes  necessary  in  the  reeducation  of  these  patients, 
in  the  persuasion  of  their  minds  out  of  the  diseased  ruts  of  their 
habitual  thinking,  actually  to  stand  up  before  them,  to  wax  elo- 
quent, to  plead  their  cause  of  health  as  an  advocate  would  seek 
to  save  his  client  the  bar.     Argument   after  argument 

must  be  presented,  illustration  after  illustration  must  be  utilized, 
to  drive  home  to  the  patient  the  error  of  his  thoughts  and  the 
sin  of  his  thinking.  It  is  necessary  literally  to  hammer  the 
new  ideas  on  the  mind  during  the  earlier  stages  of  treatment. 
Tt  is  never  safe  to  tell  the  patient  of  a  diagnosis  without  at 
the  same  time  emphatically  assuring  him  that  the  disease  is 
curable.  The  emphatic  assertion  of  curability  must  unfail- 
ingly accompany  diagnosis. 

And  so  the  reeducation  of  the  will  is  accomplished  by  simple 
and  direct  methods  of  psychological  teaching,  by  earnest  and 
eloquent  inspiration  of  the  patient,  and  by  suitable  social  sup- 
port in  the  way  of  help  from  the  domestic  circle  and  other 
helpful  association  with  strong-willed  and  uplifting  minds.  And 
it  is  even  possible  in  the  case  of  other  patients  who  may  be 
hopelessly  sick,  greatly  to  help  them  by  proper  advice  and 
suggestion. 

Billroth  once  said: 

The  patient  comes  to  the  physician  for  advice,  consolation,  and 
hope;  if  you  give  him  nothing  of  this,  you  may  be  an  excellent  diag- 
nostician and  prognosticator,  but  you  are  no  doctor. 

PSYCIIAXALYSIS 

It  not  infrequently  happens  that  some  group  or  groups  of 
ideas  which  become  formulated  in  the  mind,  for  some  reason 
or  other,  are  unacceptable  to  the  mind  as  a  whole.     The  per- 


MODERX  PSYCHOTHERAPY  283 

sonality  —  the  mind  —  fails  properly  to  assimilate  this  particu- 
lar group  of  ideas.  The  mind  is  active  to  subjugate  these  ideas 
and  emotions,  it  tries  to  submerge  and  suppress.  But  it  often 
appears  that  this  temporarily  suppressed  and  rejected  complex 
has  acquired  the  power  and  dignity  of  a  separate  and  automatic 
existence;  and  thus  it  continues  to  act  the  role  of  a  mischief- 
making  intruder  in  the  commonwealth  of  the  mind,  just  as 
some  foreign  body  would  produce  troubles  in  the  physical 
organization.  And  thus  it  would  appear  that  many  forms 
of  psycho-neurosis,  such  as  worry,  or  obsession,  are  indirectly 
due  to  this  incomplete  digestion,  this  crippled  mental  assimila- 
tion and  elimination. 

Professor  Freud  years  ago  called  attention  to  the  fact  that 
a  great  number  of  the  common  psycho-neuroses  owe  their 
origin  to  a  protracted  conflict  or  disagreement  between  two 
groups  of  ideas  or  two  inharmonious  modes  of  thinking.  To 
illustrate  this  theory  of  the  origin  and  nature  of  many  of  our 
mental  difficulties,  let  us  suppose  that  a  highly  conscientious 
and  religious  person  should  passingly  conceive  the  idea  of  com- 
mitting some  shocking  crime.  The  thought  of  this  wickedness 
arises  in  his  consciousness,  but  it  so  shocks  and  horrifies  his 
moral  sensibilities  that  he  immediately  represses  and  disowns 
the  idea.  Every  time  this  group  of  ideas  arises  in  his  mind  he 
again  promptly  denies  his  responsibility  therefor.  He  resists, 
combats,  represses,  denies,  and  fights  the  idea,  and  all  the 
while  his  very  mental  warfare  constitutes  an  ever-present 
source  of  auto-suggestion  which  tends  to  grow  stronger  and 
stronger,  impelling  him  to  do  the  very  thing  he  is  fighting  to 
keep  from  doing. 

The  methods  of  psycho-analysis  would  suggest  that  the 
tempted  and  tortured  soul  promptly  recognize  this  wicked  group 
of  ideas  as  a  dangerous  intruder  into  an  otherwise  peaceful, 
well-disposed  intellect,  and  that  its  existence  be  fully  acknowl- 
edged. Further,  instead  of  making  incessant  resistance,  he 
should  begin  the  process  of  full  acceptance  and  immediate  di- 
gestion and  assimilation  of  the  idea,  and  then  promptly  and  ef- 
fectively eliminate  the  whole  thing  from  the  mind,  leaving  be- 
hind onlv  the  memory  of  having  effected  its  overthrow. 


284  WORRY  AND  NERVOUSNESS 

AUXILIARY    CURES 

In  this  chapter  I  have  endeavored  briefly  to  summarize  and 
concisely  to  outline  the  various  accepted  methods  of  practice 
in  modern  psychotherapy.  The  remaining  chapters  of  this  book 
are  devoted  to  a  more  full  and  complete  delineation  of  the  prac- 
tical application  of  these  various  methods,  and  it  will  be  best 
at  this  time,  only  for  the  purpose  of  completing  our  summary, 
to  note  the  various  auxiliaries  that  are  called  into  service  to 
aid  us  in  the  treatment  and  cure  of  these  various  forms  of 
nervous  disorders.  By  auxiliary  methods,  we  refer  to  the  great 
and  helpful  influence  of  religious  faith,  the  profoundly  quiet- 
ing effect  of  spiritual  confidence,  the  sublime  peace  and  recon- 
ciliation which  accompanies  the  presence  of  an  eternal  hope 
within  the  human  soul. 

As  auxiliaries  in  the  treatment  of  psychic  disturbances  should 
also  be  mentioned  the  work,  travel,  adventure,  rest,  and  study 
cures,  together  with  all  other  means  of  diversion  and  digression, 
which  are  more  fully  and  appropriately  considered  in  the  chap- 
ters which  follow. 

SUMMARY   OF   THE   CHAPTER 

1.  Mind  cure  is  as  old  as  the  race.  Psychotherapy  is  not  a 
new  healing  art. 

2.  Mind  cure  is  evolving  from  its  former  empiric  crudeness 
into  a  generally  recognized  and  accepted  science. 

3.  The  moment  the  medical  profession  espoused  psychotherapy, 
mind  cure  was  robbed  of  its  superstitions  and  supernatural  ele- 
ments. 

4.  The  spiritistic  mind  cure  cults  of  today  are  but  natural 
reactions  to  the  materialism  of  the  last  century. 

5.  Mind  cure  is  now  rapidly  passing  as  a  religion,  a  cult,  or  a 
creed. 

6.  Psychotherapy  embraces  all  methods  of  mental  training  de- 
signed to  prevent,  to  relieve,  or  cure  functional  disturbances. 

7.  The  nervous  mechanism  of  the  body  may  be  excited  by  both 
physical  and  psychic  stimuli. 

8.  Man  is  highly  suggestive;  the  human  baby  is  the  most 
highly  imitative  creature  in  the  world. 

9.  The  field  of  remedial  suggestion  consists  of  autosuggestion, 
therapeutic  suggestion,  and  environmental  suggestion. 

10.  Therapeutic  suggestion  may  be  indirect  or  hidden,  but  the 
direct  or  educational  method  is  preferable. 


MODERN  PSYCHOTHERAPY  285 

11.  Psychic  substitution  is  the  secret  of  success  in  the  elimina- 
tion of  undesirable  ideas. 

12.  Sympathy  and  persuasion  are  all-powerful  in  the  hands 
of  the  expert  psychotherapist. 

13.  The  pleasant  smile  and  the  hearty  handshake  are  more 
effective  in  the  neuroses  than  all  of  the  doctor's  remedies. 

14.  The  goal  of  psychotherapy  is  will-training  —  to  make  the 
patient  a  thorough  master  of  himself. 

15.  Reeducational  therapeutics  should  be  practiced  without 
artifice  —  free    from  therapeutic  deceptions. 

16.  Reeducation  is  accomplished  by  direct  teaching,  eloquent 
inspiration,  and  helpful  association. 

17.  Psychanalysis  represents  an  effort  to  analyze,  diagnose, 
and  eliminate  harmful  ideas  by  the  newer  methods  suggested  by 
Freud. 

18.  The  auxiliary  cures  of  psychotherapy  embrace  religious 
faith,  the  work,  travel,  rest,  and  study  cures. 


CHAPTER  XXIII 
PSEUDO-PSYCHOTHERAPY  —  MENTAL    DECEPTION 

FROM  time  immemorial  the  shrewd  and  unscrupulous  have 
been  able  to  make  a  living  by  deceiving  and  imposing 
upon  their  credulous  and  unsuspecting  fellows.  The  world's 
greatest  fakers  and  imposters  have  had  sufficient  wisdom  and 
foresight  to  perpetrate  their  pious  frauds  upon  the  public  under 
the  guise  of  mental  culture  cults  and  divine  healing  religions. 
Centuries  of  education  has  destroyed  but  little  of  our  belief 
in  omens,  portents  and  charms ;  has  done  little  to  lessen  our 
love  of  the  occult,  the  mystical,  and  the  marvelous. 

MEDICAL    SUPERSTITION 

Notwithstanding  the  present  day  widespread  diffusion  of 
scientific  information,  thousands  of  people  believe  in  charms, 
they  worship  at  shrines,  they  adore  relics,  they  have  such  faith 
in  the  lurid  advertisement  of  a  patent  medicine  that  it  some- 
times appears  to  really  do  them  good  in  spite  of  the  deleterious 
drugs  it  often  contains.     (Fig.  10.) 

It  must  also  be  evident  that  if  people  had  the  same  faith  in  them- 
selves that  they  have  in  the  nostrum  vender  and  the  exponents  of 
commercialized  religion,  and  pursued  the  common  sense  methods  of 
combating  functional  nervous  disorders  suggested  by  medical  science, 
they  would  have  the  moral  satisfaction  of  achieving  a  cure,  without 
becoming  the  stultified  dupes  of  designing  frauds.  It  is  evident  that 
the  so-called  diseases  over  which  the  wonder-working  charlatan  tri- 
umphs so  signally,  are  not  real  diseases  at  all.  but  merely  symptoms 
of  the  various  functional  nervous  disorders  already  considered. 

People  still  have  the  bumps  on  their  heads  felt  by  professional 
phrenologists,  while  palmists  earn  an  easy  living  holding  their 
clients'  hands  and  scrutinizing  their  faces.  Fortune  tellers 
thrive  as  long  as  the  authorities  do  not  lodge  them  in  jail,  and 

286 


PSEUDO-PSYCHOTHERAPY  287 

clairvoyants  still  practice  and  prosper  where  legal  obstacles 
do  not  prevent  them.  All  of  these  various  forms  of  fraud  and 
fakery,  and  the  ease  with  which  they  are  perpetrated  upon  the 
twentieth-century  public,  only  serve  to  demonstrate  how  sus- 
ceptible is  the  average  mind  to  deception  along  the  lines  of 
mental  healing. 

When  some  striking  phenomena  suddenly  appears,  claiming 
to  be  the  new  and  only  genuine  religion  direct  from  Heaven 
above,  and  offering  as  credentials  of  its  divine  authenticity  the 
fact  that  its  high  priest  and  chief  promulgator  can  lay  his  hands 
upon  the  heads  of  the  sick  and  afflicted  and  immediately  they  are 
healed  —  spring  up  healthy  and  whole  —  then  hundreds  of  hon- 
est souls  are  ready  to  forsake  all  and  follow  the  healer  and  his 
new  religion.  (See  Fig.  10.)  Old  Brother  Barnum  said  that 
people  liked  to  be  humbugged,  and  it  seems  to  me  that  they 
sometimes  greatly  prefer  divine-healing  humbugs.  There  is 
that  mystical  fascination  —  that  enthusiasm  of  the  crusaders  — 
connected  with  these  new  and  spectacular  religions  that  appeals 
with  peculiar  force  to  the  human  mind,  especially  if  the  human 
mind  happens  to  be  of  that  peculiar  variety  which  dwells  in 
the  free-thinking,  adventurous  brain  of  the  sovereign  American 
citizen. 

Just  a  few  weeks  ago  there  came  to  see  me  a  splendid  young 
woman  who  was  almost  a  complete  nervous  wreck  as  a  result 
of  going  to  consult  a  palmist,  who  had  discovered  some  evil 
omen  crossing  her  "  life  line,"  which  she  suggested  might  mean 
serious  trouble  in  the  patient's  later  life.  This  the  patient  in- 
terpreted as  a  liability  to  go  crazy,  and  she  proceeded  immedi- 
ately to  set  all  her  mental  and  nervous  powers  at  work  along  the 
lines  of  doing  the  very  best  she  could  to  go  crazy  just  as  soon 
as  possible;  and  not  until  we  had  repeatedly  assured  her,  and 
many  times  admonished  her,  that  the  palmist  knew  nothing 
about  what  she  was  talking  about,  while  we  did  know  some- 
thing about  what  we  were  saying  when  we  assured  her  that 
there  was  no  evidence  of  insanity  in  her  case,  did  she  return  to 
a  normal  mental  condition.  She  had  been  out  of  sorts  with 
her  family  and  unable  to  earn  her  living  for  over  eighteen 
months  as  a  result  of  this  single  visit  to  the  palmist.     (Fig.  10.) 


288  WORRY  AND  NERVOUSNESS 

SPIRITISM   AND  THE  SUPERNATURAL 

Thousands  of  educated  people  who  cannot  be  imposed  upon 
by  clairvoyants,  palmists,  or  crystal-gazers,  or  who  cannot  be 
misled  by  the  more  palpable  healing  frauds  and  fakes,  fall  easy 
victims  to  the  teachings  of  trance  mediums  and  spiritualistic 
practitioners.  (Fig.  10.)  The  psychology  and  physiology  of 
trances  and  allied  states  I  have  fully  considered  elsewhere  and 
space  will  not  permit  of  their  discussion  at  this  time.  Suffice 
it  to  say,  the  majority  of  trance  mediums,  no  doubt,  honestly 
believe  themselves  to  be  the  channel  of  communication  between 
Heaven  and  earth,  and  it  is  their  enthusiasm  and  earnest  con- 
fidence in  their  own  work,  coupled  with  the  fact  that  they  are 
sometimes  really  insane,  that  gives  such  peculiar  influence  and 
power  to  their  teaching. 

And  in  this  connection  we  might  treat  of  another  group  of 
modern  mental  teaching,  such  as  mental  telepathy,  magnetic 
healing,  etc.  However  remarkable  may  be  the  phenomena  ap- 
parently connected  with  so-called  telepathic  experiences,  we 
can  only  herewith  record  the  fact  that  there  exists  today  no 
scientific  proof  of  the  existence  of  any  such  a  thing  as  mental 
telepathy. 

I  do  not  for  a  moment  undertake  to  say  that  I  am  personally 
able  to  explain  all  the  phenomena  connected  with  spiritualistic 
mediums  and  their  seances.  Personally,  I  am  a  believer  in  su- 
pernatural influences;  but  I  am  not  at  all  persuaded  that  all 
supernatural  agencies  are  good  in  their  influence,  and  from  what 
I  know  of  spirit  mediums  and  spiritualism  (if  it  should  prove 
in  the  end  to  be  supernatural  in  origin),  I  think  I  have  already 
made  up  my  mind  as  to  what  sort  or  manner  of  spirit  is  con- 
nected with  these  manifestations.  I  look  upon  spiritualism  as  a 
problem  largely  outside  of  the  pale  of  scientific  investigation, 
although  many  phases  of  the  phenomena  are  subject  to  both 
physiological  and  psychological  study. 

Whether  cure  and  health  are  worth  while  at  all,  if  the  intel- 
lect must  be  thus  deceived  and  stultified  by  cheap  performances 
and  crude  mysticism,  may  be  well  doubted.  And  it  may  be 
questioned,  too,  whether  such  cures  are  really  genuine  cures  at 


THE  DRUG  DELUSION 


FAITH  CURE  HEALING 


PALMISTRY   DECEPTIONS  5PURJ0US  S?irLIi^L 

Fig.  10.   Fraudulent  Methods  of  Healing 


PSE  U  DO-PS  YCHO  THERAPY  289 

HYPNOTISM 

Hypnotism  may  consist  of  the  hypnoidal  state,  in  which  the 
patient  is  really  awake  but  in  a  passive  state  of  mind,  ready 
to  receive  the  suggestion  and  teachings  of  the  healer,  on  down 
through  increasing  passivity  to  a  profound  state  of  hypnosis,  in 
which  the  patient  is  oblivious  of  his  surroundings  and  under 
comparatively   full   control   of  the  hypnotizer. 

Hypnotism  is  basically  wrong,  as  a  method  of  strengthening 
the  intellect  and  educating  the  will,  in  that  it  leads  its  vic- 
tims to  depend  more  and  more  upon  the  hypnotic  operator. 
Hypnosis  is  certainly  not  a  natural  state  of  mind;  it  is  highly 
artificial  and  unnatural.  Some  authorities  have  endeavored  to 
show  that  hypnotic  sleep  was  analogous  to  natural  sleep,  but 
this  is  certainly  a  mistake.  The  hypnotic  state  may  in  some 
respects  resemble  the  somnambulistic  state,  but  somnambulism 
is  not  a  state  of  natural  and  normal  sleep.  Hypnosis  is  not  one 
of  nature's  remedial  agents. 

We  believe  that  human  beings  are  free  moral  agents,  kings 
and  queens  in  their  own  domains,  and  that  the  Creator  never 
intended  that  our  minds  should  submit  to  be  dominated  by,  be 
dictated  to,  or  be  controlled  by  any  mind  in  the  universe  except 
that  of  man's  Maker.  Hypnotism  necessitates  the  surrender  of 
the  mind  and  will  in  a  peculiar  way  to  the  influence  of  another 
personality ;  and  we  regard  these  procedures  as  unscientific  and 
un-Christian,  and  in  the  highest  degree  subversive  of  individual 
strength  and  stamina  of  character. 

The  employment  of  hypnotism  in  psychotherapeutic  procedure 
is  with  the  idea  of  increasing  the  suggestibility  of  the  patient 
and  facilitating  the  formation  of  new  and  healthy  complexes  in 
his  psychic  life.  While  it  must  be  admitted  that  hypnotism  does 
greatly  increase  suggestibility,  it  has  been  found  that  this  state 
is  transient  and  the  desired  effects  are  not  permanent.  It 
further  appears  that,  when  skilfully  made,  suggestions  are  just 
as  acceptable  and  influential  to  the  waking  mind  as  to  the 
sleeping:  while  the  newer  processes  of  reeducation  and  psy- 
chanalysis  can  in  no  possible  way  be  assisted  by  the  employment 
of  hypnosis.  Hypnotism  has  been  enthusiastically  tried  —  and 
found  woefully  wanting.    Its  value  is  demonstrated  only  in  cer- 


290  WORRY  AXD  NERVOUSNESS 

tain  rare  cases,  and  in  connection  with  perfecting  the  mental 
diagnosis  in  certain  difficult  and  obscure  psychic  disorders. 

WHAT   HYPNOTISM   IS  NOT 

While  the  author  has  come  to  recognize  hypnotism  as  having 
but  little  or  no  value  in  the  practice  of  psychotherapy,  never- 
theless, there  are  pertain  misconceptions  of  this  practice  which 
should  be  set  right  in  the  public  mind.  These  wrong  ideas 
of  the  nature  and  practice  of  hypnotism  may  be  summarized 
as  follows : 

1.  Hypnotism  is  in  no  way  related  to  spiritism  and  kindred 
cults.  Hypnotism  is  a  phenomenon  pertaining  to  natural  law, 
and  unconnected  with  spiritism. 

2.  It  is  generally  supposed  that  a  person  to  be  hypnotized 
must  lose  consciousness,  but  this  is  a  mistake ;  many  practitioners 
of  hypnosis  seldom  place  their  patients  beyond  that  drowsy 
stage  known  as  the  hypnoidal  state,  in  which  the  subject  is 
really  awake  and  conscious. 

3.  It  is  commonly  believed  that  weak-minded  people  form 
the  best  subjects  for  hypnotism,  but  this  also  is  a  mistake. 
Strong-minded  and  well-educated  persons,  when  willing,  are 
most  readily  hypnotized. 

4.  While  most  people  can  be  hypnotized,  if  they  are  willing, 
no  person  can  be  put  into  a  hypnotic  sleep  against  his  will. 

5.  Hypnotism  cannot  be  used  to  compel  persons  to  commit 
crime.  Hypnotized  subjects  will  never  do  things  which  are 
contrary  to  the  standards  and  practices  of  their  moral  nature. 

CHRISTIAN    SCIENCE 

The  most  notable  of  the  modern  healing  cults  is  Christian 
Science.  As  someone  has  said,  Airs.  Eddy  was  shrewd  enough 
to  make  a  "  cult  out  of  common  sense  and  a  religion  from  a 
page  of  psychology."  Christian  Science  is  extraordinarily 
worldly-wise.  Its  founders  took  well  into  account  the  psycho- 
logical fact  that  the  mind  is  ruled  by  emotions  rather  than  by 
reason. 

Christian  Science  and  kindred  healing  cults  do  not  fail  to 
recognize  that  diseased  ideas  and  unhealthful  emotions  cannot 


PSEUDO-PSYCHOTHERAPY  291 

be  gotten  rid  of  by  the  mere  forming  of  resolutions  and  the 
swallowing  of  nauseous  drugs.  Accordingly,  they  set  to  work, 
by  means  of  a  sort  of  mental  homeopathy,  to  attack  and  over- 
throw superstition  and  credulity  with  a  more  powerful  super- 
stition—  with  a  system  of  teaching  that  must  be  accepted  by 
faith  because  it  is  impossible  of  understanding  in  the  light 
of  reason  and  judgment.  Christian  Science  thus  compels 
nervous  sufferers  unconsciously  to  use  certain  latent  energies 
which  they  little  suspected  were  resident  within  their  own 
minds,  and  Mrs.  Eddy  made  doubly  sure  that  her  followers 
would  be  forever  delivered  from  the  realms  of  imaginary 
disease  by  starting  out  with  the  denial  of  the  existence  and 
reality  of  all  diseases. 

WHY  PEOPLE  BELIEVE  CHRISTIAN  SCIENCE 

Thousands  of  people  believe  in  so-called  Christian  Science, 
not  because  they  understand  it  or  accept  all  its  teachings,  but 
because,  in  the  absence  of  any  better  teaching,  they  were  liter- 
ally driven  to  it  in  an  effort  to  find  the  peace  and  happiness 
which  come  as  a  result  of  deliverance  from  fear.  Christian 
Science  and  its  philosophy  are  certainly  not  upheld  by  the 
conclusions  of  modern  science ;  and  as  far  as  the  author  has 
been  able  to  discern,  Christ  never  on  any  occasion  required 
His  followers  to  dethrone  their  reason  and  believe  in  His 
formulas  and  teachings  in  a  blind  and  unreasoning  manner. 

Christian  Science  seems  to  be  the  emphasis  of  the  denial  ele- 
ment in  psychotherapy.  Its  disciples  deny  the  existence  of  those 
influences  which  they  are  desirous  of  evading  or  avoiding. 
Christian  Scientists  think  of  health  and  happiness  as  the  natural 
heritage  of  man,  and,  believing  this  to  be  true,  they  lay  hold 
of  these  influences  as  their  normal  mode  of  life,  and  have 
probably  experienced  them  more  than  any  other  body  of  pro- 
fessed Christians  in  the  world. 

It  is  certainly  a  sad  commentary  upon  the  orthodox  teach- 
ings of  professed  Christians,  who  claim  to  follow  the  teach- 
ings of  Jesus,  to  contrast  the  downcast  and  discouraged  attitude 
of  most  church  members  with  the  good  cheer  and  happiness 
which  the  average   Christian   Scientist  enjoys,  in  spite  of  the 


292  WORRY  AND  NERVOUSNESS 

confusing  teachings  of  his  system.  It  is  certainly  greatly  to 
the  credit  of  Christian  Scientists  that  they  have  got  what  health 
and  happiness  they  have  out  of  the  truth  at  their  disposal,  and 
their  success  certainly  constitutes  a  stunning  rebuke  to  the  mod- 
ern teachers  and  exponents  of  Christianity. 

HOW    CHRISTIAN    SCIENCE  WORKS 

An  illustration  of  the  practical  outworkings  of  Christian 
Science  is  afforded  by  a  patient  who  came  to  us  for  a  surgical 
operation,  but  who  had  been  formerly  cured  of  stomach  trouble 
by  Christian  Science,  and  this  is  the  story  she  told  of  her 
deliverance,  through  Science,  from  the  terrors  of  dyspepsia. 

"I  read  in  Science  and  Health  that  one  should  take  no  thought 
about  what  they  should  eat,"  [this  patient  seemed  to  take  it  for 
granted  that  this  thought  was  original  with  Christian  Science, 
forgetting  that  it  was  Christ  who  said  '  take  no  thought  what  ye 
shall  eat ']  "  and  I  at  once  saw  what  a  mistake  I  had  been  mak- 
ing in  studying  foods  and  trying  to  diet  myself,  and  I  resolved 
to  follow  the  new  light.  I  paid  absolutely  no  attention  to  my 
diet  from  that  time  on.  My  appetite  immediately  improved  and 
my  digestion  was  soon  perfect.  I  began  to  increase  in  flesh; 
in  fact,  I  was  a  marvel  to  all  my  friends  and  neighbors,  and 
even  the  former  physician  of  our  family  admitted  that  some- 
thing had  happened  which  was  inexplicable  to  him." 

Xow,  the  psychology  of  this  case  is  very  easy  of  under- 
standing. This  highly  suggestible  patient  received  as  a  divine 
command  the  statement  she  read  from  Mrs.  Eddy's  book.  Imme- 
diately the  stomach  was  relieved  from  the  nervous  and  incessant 
watchcare  it  had  been  subjected  to  (remember,  no  self-respect- 
ing stomach  ever  does  good  work  when  it  is  watched),  and  so 
her  digestion  began  to  improve,  her  new  state  of  mind  was 
better  than  any  known  medicine,  her  mind  was  diverted  and  her 
attention  focused  upon  her  daily  efforts  to  comprehend  and  un- 
ravel the  incomprehensible  and  the  unravelable  teachings  of 
Mrs.  Eddy's  book;  and  the  result  of  this  indifference  to  food 
and  the  earnest  effort  to  obey  the  injunction  "take  no  thought 
what  ye  shall  eat,"  enabled  her  to  give  little  thought  to  what  she 
did  eat,  while  she  took  no  thought  as  to  how  she  would  digest 


PSEUDO-PSYCHOTHERAPY  293 

it.  This  in  itself  was  sufficient  tremendously  to  whet  her  ap- 
petite, and  the  end  of  it  all  was,  her  dyspepsia  was  cured.  It 
was  nervous  dyspepsia  to  begin  with  —  psychic  indigestion. 

THE  ELIMINATION   OF  FEAR 

Christian  Science  practices  and  prospers  because  it  does,  for 
the  time  being,  quite  effectually  eliminate  fear.  Its  followers 
make  no  effort  to  appeal  to  the  student's  reason,  they  deal  with 
faith  and  emotion.  Fear  is  overcome  by  the  emotion  of  faith. 
It  is  true,  thinly,  but  nevertheless  effectively,  disguised  as  a 
system  of  religious  belief.     I  quote  one  of  their  own  writers: 

Mortal  ills  are  but  errors  of  thought;  diseases  of  mortal  mind,  and 
not  of  matter ;  for  matter  cannot  feel,  see,  or  report  pain  or  disease. 
Disease  is  a  thing  of  thought,  and  fear  is  the  procurator  of  the 
thought,  which  causes  sickness  and  suffering.  Remove  this  fear,  by 
the  true  sense  that  God  is  love  —  and  that  love  punishes  nothing  but 
sin  —  and  you  can  then  look  up  to  the  loving  God,  and  know  that  he 
afflicteth  not  willingly  the  children  of  men,  who  are  punished  because 
of  disobedience  to  His  moral  law.  His  law  of  Truth,  when  obeyed, 
removes  every  erroneous  physical  and  mental  state.  The  belief  that 
matter  can  master  Mind,  and  make  you  ill  scientifically,  is  an  error 
that  Truth  must  destroy. 

The  wonderful  change  that  comes  over  some  nervous  women 
after  joining  Christian  Science  or  a  kindred  cult,  is  sometimes 
astonishing.  Their  families  are  at  last  released  from  their  long 
bondage  to  and  suffering  from  nervous  whims,  little  by  little 
the  patients  regain  their  equilibrium  and  ere  long  are  able  to 
again  take  their  place  among  the  world's  workers,  and  it  is  no 
wonder  that  other  sufferers  who  witness  the  restoration  of  one 
such  nervous  wreck  back  to  spheres  of  usefulness  and  influence, 
are  themselves  inspired  to  believe  in  Science  as  the  great 
medicine  and  religion  of  the  hour. 

SELF-DISCIPLINE 

Christian  Scientists  themselves  recognize  that  it  is  nerve  train- 
ing and  mind  discipline  that  effects  these  cures,  but  they  equally 
recognize  that  a  scientific  propaganda,  as  such,  would  be  shorn 
of  its   great  power   of   religious   suggestion  —  of   supernatural 


294  WORRY  AXD  NERVOUSNESS 

authority  and  of  confidence  commanding  possibility.  That 
some  of  their  teachers  do  recognize  this  is  to  be  true  is  shown 
from  the  following  quotation  from  Christian  Science  Healing, 
Its  Principles  and  Practice: 

We  think  everybody  knows  and  accepts  that  the  nobler  you  become, 
the  nobler  your  influence.  And  yet  we  are  aware  there  are  persons 
who  would  agree  to  all  this,  and  nevertheless  be  frightened  away  by 
the  word,  self-training.  A  little  practice  will  make  felt  what  no  tell- 
ing or  talking  could  get  any  one  to  believe,  that  the  better  you 
prepare  yourself,  by  proper  use  of  Denial  and  Affirmative,  the 
clearer  you  become  ;  the  more  rapidly  you  can  perceive  the  way  to 
remove  error  (disorder)  and  so  heal.  In  fact,  it  might  be  said  that 
every  bit  of  such  training  you  give  yourself  could  actually  be  counted 
as  in  immediate  connection  with  every  bit  of  good  you  achieve.  This 
may  be  either  in  future  healing,  by  perceiving  what  error  you  have 
to  cast  out,  or  in  daily  life,  by  casting  it  out,  almost  without  recog- 
nizing what  you  are  doing.  The  saying  over  of  any  denials  or 
affirmations  is  but  one  part  of  self-training,  of  course;  upon  the 
saying  must  follow  duty. 

EXPLANATION    OF  THE   CURES 

Christian  Science  in  common  with  numerous  other  of  the 
modern  psychic  cults  operates  for  the  cure  of  disease  along 
the  following  general  lines: 

1.  They  all  are  a  powerful  popular  protest  against  modern 
materialism  and  rationalism. 

2.  These  psychic  systems  of  healing  are  an  unconscious  pro- 
test against  wholesale  drug-medication  and  other  unnatural 
and  irrational  methods  of  treating  disease. 

3.  Christian  Science  and  kindred  cults  are  easy  to  believe: 
they  involve  but  little  self-sacrifice  or  personal  humiliation. 

4.  These  new  psychic  cults  are  pleasant  to  the  natural  man, 
in  that  they  deny  or  ignore  the  orthodox  doctrines  of  sin,  and 
exalt  erring  man  to  the  place  of  a  god. 

5.  Christian  Science  and  allied  cults  are  new  and  therefore 
entertaining;  they  are  more  or  less  mysterious  and  therefore 
fascinating;  and  this  latter  property  they  will  undoubtedly  ever 
retain.  Their  teachings  are  unquestionably  unfathomable  — 
they  will  always  be  surrounded  by  the  aroma  of  mystery. 


PSEUDO-PSYCHOTHERAPY  295 

6.  All  their  psychic  teachings  afford  immediate  deliverance 
from  an  accusing  conscience. 

7.  Christian  Science  prospers  because  it  eliminates  worry, 
notwithstanding  the  fact  that  its  philosophy  is  unscientific. 

8.  These  occult  teachings  chloroform  the  judgment  and 
reason.  They  are  systems  of  blind  and  emotional  belief,  and 
involve  the  unconditional  surrender  of  the  mind  to  the  thing 
believed. 

9.  Christian  Science  represents  the  uplifting  power  of  faith 
and  strong  resolution,  and  only  goes  to  show  the  powerful 
influence  of  the  mind  over  the  body  when  thoroughly  dedicated 
to  a  single  idea,  even  though  that  idea  be  essentially  wrong. 

10.  It  is  a  species  of  mental  deception  which  the  believer  can 
be  taught  to  practice  upon  himself;  and  the  very  deceptiveness 
of  it  constitutes  both  its  charm  and  its  compelling  power  over 
those  who  surrender  to  it. 

11.  Last,  but  not  least,  many  of  these  systems  of  healing, 
including  Christian  Science,  have  gone  on  in  the  world  in  spite 
of  their  error,  because  they  do  contain  a  grain  of  truth  not  fully 
recognized  by  either  scientists  or  religionists  —  the  influence 
of  mind  over  matter. 

NEW    THOUGHT 

I  would  have  my  readers  understand  that  I  do  not  confuse 
Xew  Thought  with  Christian  Science.  There  can  be  no  question- 
ing the  fact  that  the  various  wings  of  the  Xew  Thought  move- 
ment have  done  a  great  deal  of  good  in  the  world.  They  have 
brightened  up  the  minds  and  cheered  up  the  souls  of  thousands 
of  despondent  and  downcast  sufferers.  The  one  redeeming 
feature  about  the  psychic  teachings  of  the  Xew  Thought  advo- 
cates is  that  they  have  not  sought  to  promulgate  a  new  religion 
or  establish  themselves  as  the  only  and  genuine  religious  teach- 
ers for  the  present  generation.  They  have  not  clothed  their 
every  utterance  with  the  assumption  of  infallibility.  They  do 
not  claim  to  be  all-inspired,  as  do  the  Christian  Scientists,  and 
there  is  much  to  be  commended  in  the  method  and  manner  of 
their  work,  although  I  am  decidedly  adverse  to  this  business 
of  taking  an  old  truth,  restating  it,  dressing  it  up  in  new  and 


296  WORRY  AND  NERVOUSNESS 

modern  language,  and  then  offering  it  to  the  world  as  a  new 
discovery  in  the  realms  of  philosophy  or  religion. 

DOWIEISM 

Of  all  modern  healing  cults  which  confuse  and  confound  sick- 
ness and  sin,  and  claim  to  heal  all  disease  by  means  of  prayer, 
Dowieism  stands  out  as  the  most  recent  and  best  known.  Its 
basic  error  consists  in  regarding  sickness  and  sin  as  analogous, 
and,  therefore,  if  God  will  forgive  sin  in  answer  to  prayer, 
why  will  He  not  also  cure  sickness  in  answer  to  prayer?  But 
sin  and  sickness  are  not  analogous.  You  can  be  forgiven  for 
sowing  thorns  and  thistles  in  your  backyard,  but  that  does  not 
remove  the  thorns  and  thistles  after  you  have  allowed  them  to 
grow  up.  It  will  take  hard  work  in  addition  to  prayer,  to 
clear  the  thorns  and  briers  out  of  the  backyard. 

The  secret  of  the  success  of  these  bogus  systems  of  divine 
healing,  as  noted  in  former  chapters,  is  the  power  of  sug- 
gestion—  nothing  more,  and  nothing  less.  The  future  will  no 
doubt  witness  the  birth  of  many  new  systems  of  so-called  faith 
healing.  They  are  all  based  upon  the  psychology  and  physiology 
of  faith  and  fear,  as  well  as  upon  the  error  that  when  one  is 
sick,  his  body  is  possessed  of  a  devil,  and  if  the  devil  could 
only  be  cast  out,  the  sick  one  would  immediately  be  restored 
to  health. 

THE   IMMANUEL   MOVEMENT 

It  would  seem  hardly  fair  to  consider  the  Immanuel  move- 
ment at  the  close  of  this  chapter,  for  it  has  far  more  to  be  said  in 
its  favor  than  any  of  the  psycho-religio  propagandas  thus  far 
considered.  While  this  unique  religious  movement  is  directed 
at  the  conquest  of  fear,  its  founders  seem  to  proceed  some- 
what from  the  Christian  Science  point  of  view,  in  that  they 
seem  to  have  recognized  that  common  sense  and  reason  were 
of  little  value  in  checking  the  mental,  moral,  and  physical  depre- 
dation of  tyrannical  emotions;  in  fact,  it  would  seem  to  the 
writer  that  after  recognizing  and  admitting  this  fact,  they 
deliberately  set  about  to  overthrow  the  strongholds  of  human 
emotion  by  some  sort  of  scientific  exorcism,  not,  of  course,  by 
the  crude  method  of  medieval  times,  but  by  a  persistent,  well- 


PSEUDO-PSYCHOTHERAPY  297 

organized  plan  of  strengthening  and  upbuilding  the  patient's 
faith  in  the  curative  power  of  Jesus  Christ  and  the  healing- 
possibilities  of  the  Gospel  of  Christianity  when  properly  under- 
stood. Its  founders  evidently  understood  the  tremendous  heal- 
ing powers  of  faith  and  joy,  when  allowed  to  work  their  full 
influence  in  the  human  mind  and  body. 

The  Immanuel  movement  seeks  to  maintain  this  desirable 
attitude  of  mind  by  developing  the  graces  of  the  Christian 
character,  by  the  continuously  increasing  contemplation  of  that 
wonderful  picture  of  Christ  Jesus  going  about  on  earth  two 
thousand  years  ago  healing  the  sick,  soothing  the  suffering,  and 
raising  the  dead;  and  who  can  deny  but  that  this  unique  and 
extraordinary  picture  is  able  to  exert  a  far  greater  psycho- 
therapeutic influence  upon  the  human  life  than  all  the  essays  of 
all  the  inspirational  optimists  of  all  time? 

The  optimistic  spirit  which  the  Immanuel  movement  seeks 
thus  indirectly  to  foster  and  strengthen,  the  New  Thought 
propaganda  seeks  to  present  more  directly  from  a  psychological 
standpoint;  they  (the  Xew  Thought  teachers)  preach  optimism 
as  a  doctrine,  a  mode  of  life,  a  religion;  and  optimism,  it  must 
be  confessed,  has  a  great  influence  in  producing  a  sort  of 
environmental  blindness  or  rather  a  desirable  non-resistance 
to  those  things  which  it  is  impossible  to  remove  from  one's 
environment. 

What  Immanuelism  seeks  to  do  by  theology,  New  Thought 
would  do  by  psychology ;  that  is,  to  bring  the  nerve  forces  of 
the  body  into  working  harmony  with  the  automatic  physiologi- 
cal processes  of  the  organism,  and  this  harmonious  co-partner- 
ship is  produced  by  the  cultivation  and  domination  of  the  joy- 
ful emotions  of  optimistic  faith.  The  Xew  Thought  disciple 
practices  "  going  into  the  silence  "  to  attain  these  desirable  ends, 
while  Immanuelism  advocates  relaxation  and  a  special  state 
of  mind  associated  with  prayer.  The  ultimate  psychology  of 
the  two  methods  is  about  the  same. 

THE    MASTER    KEY    OF    HEALING 

And  so  it  would  appear  that  any  practice,  procedure,  belief, 
medicine,  cult  or  ism  which  is  able  to  generate  faith  and  destroy 


298  WORRY  AXD  XERVOUSNESS 

fear,  possesses  definite  curative  powers  in  the  treatment  of  men- 
tal and  physical  disease.  The  fact  that  the  sick  and  the  suffer- 
ing recover  under  such  treatment  in  no  way  proves  that  the 
religion,  ethics,  or  other  ideas  or  ideals  of  those  who  treat  them 
are  either  right  or  wrong. 

And  so  the  law  of  mental  healing —  faith  is  a  health-producer; 
feaf  is  a  disease-producer  —  operates  when  it  is  consciously 
or  unconsciously  utilized  by  any  and  all  persons,  at  any  and 
all  times,  and  in  any  and  all  places.  If  John  Alexander  Dowie 
prayed  for  you  and  you  got  well,  your  recovery  in  no  wise  con- 
stitutes evidence  that  Dowie  was  a  better  man  than  the  minister 
who  prayed  for  you  before,  when  you  did  not  get  well.  It 
simply  means  that  Dowie's  means  and  methods  —  his  dress  and 
personal  appearance,  what  you  had  heard  about  him,  and  what 
he  said  to  you  —  resulted  in  making  such  a  mental  impression 
upon  you  that  faith  came  into  its  own,  took  possession  of  your 
mind,  routed  fear,  and  banished  doubt.  You  threw  your  whole 
mind  into  the  one  grand  conclusion  that  you  were  going  to  be 
healed,  and  many  who  did  this  were  apparently  healed,  and,  not 
understanding  the  laws  of  mind  and  matter  underlying  their 
healing,  they  immediately  espoused  the  peculiar  cause  of  the 
healer,  adopted  his  beliefs  as  their  beliefs,  his  religion  as  their 
religion,  and  his  way  of  living  as  their  way  of  living;  and  in 
this  way  vast  churches,  cults,  and  isms  have  been  built  up  in 
both  ancient  and  modern  times. 

And  so  it  becomes  apparent  that  the  healing  of  disease  by 
means  of  faith,  or  by  so-called  prayer  or  by  any  other  method, 
in  no  wise  proves  that  the  healer  is  a  special  agent  of  God, 
that  his  religion  is  the  one  true  belief,  or  that  his  ethical  teach- 
ings are  right.  Faith  is  the  master  key  which  unlocks  many 
an  ancient  medical  mystery  and  explains  many  apparent  modern 
miracles. 

SUMMARY   OF    THE   CHAPTER 

1.  The  world's  greatest  fakers  have  promulgated  their  pious 
frauds  under  the  guise  of  divine  healing  cults. 

2.  Centuries  of  education  have  not  destroyed  the  popular  belief 
in  omens,  charms,  shrines,  palmists,  clairvoyants,  and  other  com- 
mercialized disease  remedies. 


PSEUDO-PSYCHOTHERAPY  299 

3.  Spirit  mediums  and  practitioners  of  the  supernatural  exert 
a  great  influence  over  a  large  group  of  people. 

4.  Mental  telepathy  and  kindred  teachings  are  able  to  offer 
no  scientific  proofs  in  support  of  their  claims. 

5.  As  a  phenomenon  spiritualism  is  largely  outside  the  pale  of 
scientific  investigation. 

6.  Hypnotism  is  basically  wrong  as  a  method  of  treating  ordi- 
nary psychic  disorders  and  mental  disturbances. 

7.  Modern  psychotherapy  successfully  practices  the  art  of  sug- 
gestion without  incurring  the  risks  and  dangers  of  hypnosis. 

8.  Hypnotism  is  not  a  supernatural  phenomenon,  neither  can 
persons  be  hypnotized  against  their  will  or  contrary  to  their 
moral  nature. 

9.  Christian  Science  is  a  sort  of  mental  homeopathy,  as  it 
attacks  diseased  emotions  with  religious  emotions  —  supplanting 
superstition  with  greater  superstition. 

10.  Christian  Science  is  the  emphasis  of  the  denial  element  of 
psychotherapy  in  association  with  the  great  power  of  religious 
affirmation. 

11.  While  Christian  Science  may  be  unscientific  and  un-Chris- 
tian,  nevertheless,  it  is  worldly-wise,  psychologically  practical, 
and  therapeutically  successful. 

12.  Christian  Science  substitutes  the  effort  to  comprehend  its 
teaching  for  the  patient's  self-contemplation  and  disease  worry. 

13.  Christian  Science  quite  effectively  eliminates  fear  and  thus 
cures  worry. 

14.  Christian  Science  is  a  self-confessed  system  of  self-dis- 
cipline, of  will-training,  promulgated  and  practiced  as  a  religious 
system. 

15.  Christian  Science  is  a  reaction  to  materialism;  a  protest 
against  drugs,  an  antidote  for  fear,  a  poultice  to  the  conscience, 
a  psychological  novelty  to  fascinate  the  soul  and  occupy  the  mind. 

16.  Xew  thought  represents  an  effort  to  make  a  religion,  a 
mode  of  life,  out  of  the  doctrine  of  optimism. 

17.  Dowieism  represents  a  great  healing  movement  based  upon 
the  error  that  sickness  and  sin  are  synonymous. 

18.  The  Immanuel  movement  is  probably  the  most  scientific 
and  Christian  of  all  modern  pseudo-therapeutic  methods. 

19.  Faith  is  the  master  key  of  mental  medicine.  Confidence  is 
the  keystone  to  the  arch  of  healing. 


CHAPTER  XXIV 
THE  ART  OF  THERAPEUTIC  SUGGESTION 

IF  THE  influence  of  the  art  of  suggestion  in  the  realms  of 
health  and  disease  were  better  understood,  there  would  be 
much  less  of  superstition  surrounding  many  an  ancient  miracle, 
and  less  of  mystery  attached  to  many  present  day  remarkable 
and  phenomenal  cures  of  disease.  The  therapeutic  methods  of 
the  ancient  medicine  man  and  the  modern  bogus  healer  are 
alike  dependent  on  the  curative  power  of  "  suggestion."  They 
owe  their  healing  results  to  the  power  of  suggestion  to  generate 
faith  and  destroy  fear ;  and  by  suggestion  we  mean  the  systematic 
use  of  any  and  all  means  which  will  result  in  the  arousal  of 
new  ideas  or  set  in  operation  other  emotional  processes  which 
are  able  to  exert  a  favorable  or  healing  influence  upon  the 
mind  of  the  patient.  It  is  possible,  by  means  of  suggestive 
therapeutics,  to  banish  fear  and  worry,  and,  as  far  as  the 
immediate  and  physical  effects  are  concerned,  it  matters  little 
whether  these  therapeutic  suggestions  are  true  or  false  —  the 
immediate  healing  effects  are  just  the  same.  Of  course,  the 
ultimate  effects,  in  the  case  of  false  suggestion,  upon  both  the 
mental  and  spiritual  natures,  is  altogether  unfortunate  and 
undesirable. 

SUGGESTIVE  THERAPEUTICS  DEFINED 

Therapeutic  suggestion  may  be  either  direct  or  indirect.  It 
may  be  persuasive  or  it  may  be  educational  in  its  trend.  Again, 
suggestions  may  be  true  or  false  —  in  fact,  the  majority  of  our 
suggestive  therapeutics  in  the  past  has  been  tinged  with  more 
or  less  deception.  Indeed,  the  very  term  itself,  to  many  minds, 
suggests  a  sinister  sort  of  medical  deception. 

The  dictionary  definition  of  the  term  "  suggestion  "  does  not 
set  forth  the  idea  of  honest  persuasion  and  indirect  education, 

300 


ART  OF  THERAPEUTIC  SUGGESTION  301 

and  so  nervous  patients  sometimes  resent  the  term,  feeling 
that  it  implies  that  their  confidence  is  to  be  more  or  less 
imposed  upon,  that  subterfuges  are  about  to  be  employed  in 
the  treatment  of  their  disorders.  It  must  be  explained  to  such 
patients  that  suggestion  as  used  in  psychotherapy  (at  least  as 
I  understand  and  use  it)  merely  represents  the  preliminary  and 
persuasive  stage  of  educational  therapeutics  —  that  stage  in 
which  it  is  altogether  necessary  for  them  to  experience  the 
benefits  of  treatment,  but  in  which  it  is  not  always  possible 
fully  to  explain  to  their  disordered  reasoning  powers  the  every 
detail  and  wherefore  of  the  methods  of  treatment  followed  by 
their  therapeutic  teacher.  And  so  I  think  in  recent  years  the 
public  mind  has  come  somewhat  to  appreciate  this  new  meaning 
which  attaches  to  the  term  "  suggestion,"  for  we  frequently 
hear  such  expressions  as  "  that  was  a  very  suggestive  book,"  etc. 
Forel  has  given  us  a  very  good  statement  or  definition  of  sug- 
gestion as  applied  to  medicine  in  the  following  language  : 

By  suggestion  is  understood  a  very  peculiar  kind  of  psychic  (i.  e., 
mental),  or,  more  properly,  psycho-physical,  reaction,  in  which  an 
idea  —  usually  connected  with  a  perception  —  becomes  so  intense  and 
narrow,  the  mind  becoming  so  filled  with  "  one  idea,"  that  this  idea 
loses  its  ordinary  associations  with  its  corrective  counter-ideas, 
breaks  violently  through  common  restrictions,  and  releases  cerebral 
activities  that  are  usually  independent  of  it,  and  generally,  if  not 
always,  subconscious.  Suggestion  dissociates  what  is  otherwise  asso- 
ciated. Brains  in  which  dissociation  is  easy  are  therefore  especially 
suggestible.  Suggestion  generally  releases  those  activities  whose 
content  is  such  that  they  can  be  pictured  by  the  senses,  and  does  it  in 
such  a  way  that  the  "subject"  is  unconscious  throughout  of  the 
means  by  which  it  takes  place  and  is  therefore  astonished  at  what 
happens. 

THE  PSYCHOLOGY  OF  SUGGESTION 

The  three  following  paragraphs  are  from  my  work  before 
referred  to.  The  Physiology  of  Faith  and  Fear,  or  the  Mind  in 
Health  and  Disease. 

When  an  idea  becomes  uppermost  in  the  human  intellect,  when  a 
certain  notion  becomes  set  in  the  mind,  there  are  only  two  ways  of 


302 


WORRY  AND  NERVOUSXESS 


removing  it.  One  is  by  suggestion,  and  the  other  is  by  the  develop- 
ment of  the  opposite  ideas  by  a  process  of  reeducation.  Suggestion 
becomes  then,  next  to  reeducation,  one  of  the  most  successful 
methods  for  changing,  improving,  cleansing,  and  strengthening  the 
human  mind. 

The  marginal  consciousness,  by  which  I  mean  the  consciousness  of 
all  ideas  and  emotions  that  are  not  at  a  given  moment  in  the  centre 
of  the  field  of  attention,  while  it  is  normally  a  beneficent  servant, 
may,  nevertheless,  in  a  sense,  tyrannize  in  our  lives.  This  marginal 
consciousness  is  described  by  many  as  the  "  subconscious  mind.*' 
Normally,  I  say,  it  is  a  beneficent  servant,  because  in  the  marginal  or 
dim  consciousness  are  conserved  all  those  ideas  and  other  mental 
complexes  which  are  not  required  to  meet  our  present  needs.  They 
are  conserved  in  such  a  systematic  order  that  when,  in  the  course  of 
suggestion,  any  mental  process  comes  into  attention  it  brings  out 
from  this  dim  marginal  area  its  appropriate  supplement ;  and  it  is 
when  this  supplementary  image  discharges  into  motor  activity  that 
the  course  of  suggestion  becomes  complete.  This  marginal  conscious- 
ness is  a  tyrant  when  its  contents  over-freely  and  without  system 
attach  themselves  to  the  contents  of  clear  consciousness,  and  so  dis- 
turb the  balance  of  the  mind  and  render  unreliable  the  course  of 
our  judgments.  Continuously,  even  without  our  apprehension,  this 
marginal  consciousness  influences  the  character  and  the  ebb  and  flow 
of  the  processes  of  our  vivid  consciousness.  It  is  not  something 
different  and  apart  from  our  usual  conscious  life,  but  an  integral  part 
of  it. 

The  art  of  scientific  suggestion  consists  in  placing  an  idea  in  the 
mind  in  such  a  way  and  under  such  circumstances  that  it  will  become 
dominant;  that  is,  the  mind  is  caused  to  be  possessed  by  that  one 
idea.  This  dominant  idea  plays  the  role  of  a  liberator  —  it  breaks 
up  harmful  associations  of  ideas,  and  so  creates  an  opportunity  for 
the  establishment  of  new  and  healthy  groups  of  ideas.  It  brings 
about  a  dissociation  between  certain  powerful  ideas  and  physical 
actions,  and  often  dissolves  those  physio-mental  associations  which 
are  responsible  for  obsessions  and  other  bad  habits. 

SINCERITY    AND    TRUTHFULNESS 

It  is  my  settled  opinion  that  the  greatest  and  most  permanent 
good  is  to  be  accomplished  by  always  telling  the  patient  the  truth. 
I  do  not  mean  by  this  that  we  should  always  tell  our  nervous 
patients  the  whole  truth;  but  what  I  do  mean  is,  that  we  should 


ART  OF  THERAPEUTIC  SUGGESTIOX  303 

not  tell  them  anything  that  is   intrinsically  or   fundamentally 
untrue. 

In  so  far  as  it  is  desirable  to  treat  the  patient  by  suggestive 
methods,  let  us  base  our  curative  suggestions  upon  good  physio- 
logical and  psychological  law,  for  in  this  way,  and  only  in  this 
way,  can  we  hope  to  build  up  a  sure  therapeutic  foundation 
from  which  our  healing  endeavors  can  be  carried  forward  to 
completion  in  sincerity  and  with  perfect  confidence. 

And  so  in  our  efforts  to  help  the  patient  over  his  worries,  we 
must  recognize  the  possibility  of  using  both  true  and  false 
suggestions.  True  suggestions  appeal  to  the  reason,  deal  with 
facts,  point  out  causes,  and  offer  a  cure  which  is  rational  and 
right.  False  suggestions  (and  the  world  is  deluged  with  sys- 
tems of  mental  healing  based  upon  falsity  and  untruth)  appeal 
to  the  imagination.  They  aim  to  give  immediate  relief  although 
temporary;  they  aim  to  "heal  the  hurt  of  the  daughter  of  my 
people  slightly ;  "  they  seek  to  produce  immediate  effects,  no 
matter  at  what  future  expense  of  pain  to  the  body,  disappoint- 
ment to  the  mind,  or  destruction  of  the  soul.  All  methods  of 
sympathy,  suggestion,  and  advice  to  mental  sufferers  should  be 
based  upon  truth,  free  from  falsity  and  deception. 

It  is  needless  to  add  that,  in  the  author's  opinion,  the  art 
of  making  therapeutic  suggestions  is  best  practiced  by  making 
these  impressions  upon  the  patient's  mind  during  the  waking 
state.  In  the  ordinary  or  average  case  I  do  not  look  upon 
hypnotism  as  of  any  real  curative  value,  but  have  come  rather 
to  regard  it  as  a  hindrance  to  securing  permanent  results  in 
psychotherapy. 

AX     AGED    REMEDY 

Suggestion  is  literally  as  old  as  the  hills.  It  has  always  been 
the  chief  asset  of  the  successful  physician;  and  it  has  ever 
been  a  dominant  factor  in  the  work  of  the  successful  preacher. 

Xo  more  powerful  testimony  to  the  value  of  suggestion  can 
be  found  than  the  very  fact  that  there  exist  today  scores  of 
different  methods  of  treating  disease,  some  diametrically  oppo- 
site, all  of  which  are  more  or  less  successful.  Various  schools 
of  medicine  and  the  numerous  therapeutic  specialists  are  all  more 


304  WORRY  AND  NERVOUSNESS 

or  less  successful  in  treating  and  apparently  curing  disease. 
John  Alexander  Dowie  came  along  teaching  the  existence  of  a 
physical  body  afflicted  with  disease  because  the  devil  controlled 
it.  He  also  taught  that  God  heals  disease  in  answer  to  prayer, 
thus  destroying  the  devil's  power.  Dowie  cured  thousands. 
Mrs.  Eddy  and  Christian  Science  teach  that  there  is  no  physical 
body,  no  sickness;  that  these  things  exist  only  in  the  mind; 
and  likewise  they  are  able  to  cure  other  thousands.  Both  of 
these  teachings  cannot  be  true,  yet  both  can  cure  disease. 
It  is  simply  a  problem  in  suggestive  therapeutics,  and  the  ele- 
ment of  cure  is  not  the  correctness  of  either  their  physiological 
or  their  theological  teaching,  but  rather  the  intensity  and  sin- 
cerity of  the  faith  which  the  sick  one  exercises  respecting  the 
idea  upon  which  he  depends  for  healing. 

AUTOSUGGESTION 

The  ideal  method  of  treating  one's  mental  difficulties  is  by 
means  of  autosuggestion.  Form  the  habit  of  reasoning  with 
and  directly  suggesting  good  ideas  to  your  own  mind,  instead  of 
allowing  unfortunate  combinations  of  ideas  and  feelings  to 
possess  and  dominate  your  experience.  Instead  of  always  asso- 
ciating the  feelings  of  physical  fatigue  with  the  idea  of  being 
cross  and  grouchy,  try  a  little  experiment  in  suggestive  thera- 
peutics on  yourself  and  you  will  be  surprised  to  see  how  quickly 
and  effectively  it  will  work.  Some  evening  when  you  are 
completely  worn  out,  on  the  way  home  reverse  the  usual  asso- 
ciation of  idea  and  feelings  from  "  tired  and  cross  "  to  "  tired 
and  happy  "  and  keep  running  over  the  new  phrase  in  your  mind, 
something  after  the  following  fashion :  "  Tired  and  happy  " 
—  "  tired  and  satisfied"  —  ''tired  but  smiling"  —  "tired  and 
good-natured."  You  will  then  begin  to  smile  at  yourself.  It 
will  seem  a  bit  funny  at  first,  your  smile  will  soon  become 
contagious  to  the  family  and  the  entire  evening  at  home  will 
be  quite  different  as  the  result  of  the  auto-suggestion  you 
have  practiced  upon  yourself.  I  know  this  is  true  from  personal 
experiences  and  every  one  of  my  readers  also  knows  that  this 
teaching  is  entirely  true.  We  all  know  about  these  things,  but 
we  do  not  work  at  them  steadily.     One  patient  says  he  "  frets 


ART  OF  THERAPEUTIC  SUGGESTION  305 

because  he  is  tired."  In  point  of  fact,  I  think  the  principal 
reason  he  gets  so  tired  is  because  he  frets  so  much.  We  do  not 
faithfully  live  up  to  the  psychological  light  we  already  have. 

Again,  it  is  sometimes  necessary  carefully  to  train  one's  mind 
to  think  positive  thoughts;  that  is,  instead  of  constantly  saying 
to  yourself  "  I  can't  do  that,"  or,  "  I  can't  do  this,"  turn  the 
psychological  tables  suddenly  on  yourself,  yes,  literally  surprise 
yourself  by  saying:  "I  can  do  this,"  and  "I  will  do  it,"  and 
the  result  of  this  sudden  change  of  front,  on  your  personality, 
will  be  that  your  indolent  and  rebellious  mind  will  soon  swing 
around  into  obedient  lines,  and  you  will  soon  find  yourself 
accomplishing  twice  the  work  with  one  half  the  stress  and 
strain. 

Some  folks  need  to  acquire  the  power  of  rising  right  up  and 
"  talking  turkey "  to  themselves.  A  lot  of  good  people  are 
falling  down  in  life,  they  are  failing  to  make  good,  simply 
because  they  allow  their  own  lazy  brains  and  undisciplined 
minds  to  scare  them  —  literally  to  bluff  them  —  by  constantly 
harping  on  their  lack  of  ability,  their  lack  of  brains,  and  other- 
wise leading  to  such  a  degree  of  self-depreciation  that  they 
utterly  fall  down  in  the  accomplishment  of  their  life  work. 

I  stood  up  in  my  office  a  few  years  ago,  and  made  a  twenty 
minute  speech  to  a  brainy,  talented  ne'er  do  well,  about  twenty- 
seven  years  of  age,  and  much  to  my  surprise  he  pulled  himself 
together,  waked  up  and  became  a  success  in  life.  He  has  been 
simply  doing  swimmingly  ever  since,  and  I  became  convinced 
that  there  were  large  numbers  of  apparent  failures  in  life 
who  only  needed  that  some  good  Samaritan  should  come  along 
in  the  role  of  a  psychological  alarm  clock  to  wake  them  up  — 
to  set  them  earnestly  and  enthusiastically  at  work. 

THE   OVERTHROW   OF   WORRY 

Xo  amount  of  mental  resolution  and  moral  determination, 
in  and  of  themselves,  will  be  able  to  overthrow  and  cast  out 
worry.  Positive  thinking  is  not  only  required  in  the  battle 
against  worry,  but  it  is  essential  that  our  positive  thinking 
shall  also  be  opposite  thinking.  We  must  overcome  worry  with 
its  opposite  mental  states;  we  must  cultivate   faith  and  trust. 


3o6  WORRY  AND  NERVOUSNESS 

This  is  the  one  vital  factor  in  the  permanent  cure  of  worry: 
replace  the  worry  thought  with  an  opposite  thought  which  will 
occupy  the  mind  and  inspire  the  soul.  Drive  out  fear-thought 
by  exercising  faith-thought.  This  is  the  substitute  cure  for 
worry;  and  when  backed  up  by  the  strong  resolution  of  a 
determined  will  this  method  will  always  be  found  effective. 
Even  in  the  moral  and  spiritual  treatment  of  worry  it  is  the 
substitution  principle  that  works  best.  Replace  the  doubting, 
restless,  and  fretting  attitude  toward  God,  by  a  calm,  confident, 
and  trustful  belief  in  the  wisdom  of  the  Great  Mind  which  is 
directing  the  affairs  of  the  universe. 

Have  the  moral  courage  to  enforce  your  own  anti-worry 
mandates.  When  you  have  commanded  the  mind  to  cease  worry- 
ing, keep  right  after  it  and  see  that  it  does.  In  all  these  little 
things  that  harass  one's  soul,  as  some  one  has  said,  "  Don't  for- 
get to  remember  the  probability  that  you  have  not,  as  well  as  the 
possibility  that  you  have,  made  a  mistake." 

THE    ART    OF    SELF-RIDICULE 

It  is  a  great  calamity  to  form  the  habit  of  taking  one's  self 
too  seriously.  Most  of  us  take  ourselves  far  more  seriously 
than  the  world  does.  It  is  sometimes  necessary  to  tell  our 
melancholic  patients  that  it  is  impossible  for  them  to  over- 
estimate the  unimportance  of  things.  Most  nervous  people 
need  to  learn  how  to  become  indifferent  to  their  fears,  their 
feelings,  and  their  emotions. 

The  art  of  self-ridicule  —  the  ability  to  discern  the  funny  side 
of  one's  own  human  nature  —  is  a  very  effective  health  practice, 
a  genuine  mind  healing  procedure.  It  is  a  well  known  fact 
that  sometimes  when  you  are  unable  to  argue  with  or  reason 
people  away  from  their  worries,  you  can  literally  ridicule  them 
out  of  their  fears.  You  can  sometimes  help  a  woman  to  over- 
come her  absurd  fear  of  a  tiny  mouse  by  ridiculing  her  after 
all  efforts  to  reasoning  have  failed.  And  so  when  logic 
is  powerless  to  pry  you  out  of  the  slough  of  despond,  don't 
forget  to  try  a  little  wholesome  ridicule  on  yourself.  As  it 
were,  step  out  in  the  crowd  and  take  a  look  at  yourself  and 
don't  be  afraid  to  indulge  in  a  hearty  laugh  when  the  ridiculous- 


ART  OF  THERAPEUTIC  SUGGESTION  307 

ness  of  your  attitude  is  tardily  borne  home  to  your  own  con- 
sciousness. 

THE  HABIT  OF  SELF-CONTROL 

The  secret  of  success  in  the  treatment  of  nervousness  and 
cure  of  worry  is  all  bound  up  in  the  attainment  of  self-control 
—  the  science  of  self-mastery.  Whatever  the  means  of  psycho- 
therapy or  the  means  of  mental  healing,  the  one  great  object  is 
self-discipline  —  mind  training  —  will  power.  The  victor  in  the 
fight  with  fear  —  the  soldier  who  vanquished  his  nerves  —  is 
the  soul  that  bravely  dared  to  captain  its  own  mind,  who  dared 
to  out-general  his  perverted  habits  of  thought  in  the  great  game 
of  life,  whose  successful  goal  is  the  conquest  and  mastery 
of  self. 

And  so  you.  the  reader,  owe  it  to  yourself  to  summon  all 
possible  spiritual  help,  moral  resolution,  and  mental  decision,  to 
avail  yourself  of  every  physical  means  of  grace  to  the  mind, 
and  then,  having  made  a  declaration  of  emancipation  to  set 
free  the  mind  from  the  domination  of  worry  and  the  body 
from  the  tyranny  of  vice,  go  forth  into  the  world  as  sons  and 
daughters  of  God  — in  full  command  of  all  your  mental  faculties 
and  in  full  control  of  every  physical  power. 

Let  us  master  our  mental  moods,  control  our  physical  passions, 
and,  from  henceforth,  be  so  free  from  our  psychic  whims,  that 
we  shall  be  able  to  sail  straight  away  toward  our  goal  of  mani- 
fest destiny:  no  longer  will  we  allow  ourselves  to  drift  along 
aimlessly  as  the  rudderless,  helpless  bark  we  have  been,  tossed 
to  and  fro  and  up  and  down  by  every  trivial  sensation  of  pain, 
and  driven  off  our  course  by  the  whimsical  winds  of  unnatural 
fear  and  our  own  mental  confusion. 

THE   GOSPEL   OF   SURRENDER 

In  the  battle  with  "'  nerves "  there  never  fails  to  come  a 
time  when  the  secret  of  success  is  to  be  found  in  graceful  sur- 
render. In  every  fight  of  faith  to  overthrow  fear,  the  patient 
sooner  or  later  reaches  the  place  where,  for  the  time  being, 
farther  progress  is  impossible,  and  graceful  surrender  —  peace- 
ful non-resistance  —  is  the  only  course  left  open.     This  is  the 


308  WORRY  AND  NERVOUSNESS 

pass  reached  by  the  apostle  Paul,  when  he  so  pathetically  but 
bravely  wrote :  "  I  have  learned  in  whatsoever  state  I  am,  there- 
with to  be  content." 

It  is  sometimes  extremely  difficult  to  teach  the  nervous  patient 
when  to  fight  and  when  to  surrender.  As  a  general  procedure 
1  have  advised  them  somewhat  as  follows :  Assume  a  militant 
attitude  toward  your  disordered  nerves  and  disturbed  mind ; 
gird  on  the  therapeutic  armor,  begin  the  healing  fight,  and 
remain  in  the  struggle  until  both  mind  and  body  are  well  habit- 
uated to  the  spirit  of  the  conflict,  and  then,  before  the  depleted 
mental  powers  and  the  weakened  nerve  energies  are  completely 
and  fully  exhausted,  learn  how  to  relax,  surrender,  yes,  even  to 
laugh  at  and  ridicule  your  fears  and  smilingly  to  ignore  your 
sensations  of  distress  and  feelings  of  fatigue. 

CONTEMPLATION  OF  THE  GREAT 

In  this  connection  I  cannot  do  better  than  to  quote  a  clipping 
which  has  been  sent  me,  accredited  to  Dr.  Frank  Crane  and 
entitled,  "The  Practice  of  Greatness  by  Words:" 

You  take  exercises  for  the  muscles  of  your  arms,  legs  and  back : 
why  not  take  an  exercise  occasionally  for  your  soul? 

Your  spirit,  or  ego,  or  self,  or  whatever  you  may  call  that  invisible 
something  that  is  more  really  you  than  your  body;  that  something 
which  thinks,  loves,  feels,  imagines,  and  wills  is  well  worth  a  little 
training. 

Here  is  a  suggestion.  There  are  certain  great  ideas,  represented 
by  certain  great  words.  These  words  have  power-volts  in  their  very 
sound.    Every  time  you  think  one  of  them  you  grow  greater. 

Take  to  bed  with  you  the  following  seven  words.  As  you  lie, 
waiting  for  sleep,  say  them  over,  one  by  one,  to  yourself.  Or,  bet- 
ter, take  a  half  hour  during  the  day,  in  silence  and  solitude,  and 
practice  the  feeling  of  these  terms. 

i.  God.  Never  mind  about  your  belief  or  disbelief.  Say  that  word 
ten  times,  slowly,  with  pauses  between.  Think  of  what  is  above,  be- 
low, around,  and  in  all  things.  Spread  your  mind  out  upon  the  uni- 
verse.    Practice  the  sensing  of  the  infinite. 

2.  Stars.  Say  stars.  Think  stars.  Try  to  reach  the  feeling  of 
stars.  Let  your  fancy  climb  to  the  top  of  the  night  sky.  Get  the 
vibrations  of  those  measureless  distances,  those  suns,  galaxies,  sweep- 


ART  OF  THERAPEUTIC  SUGGESTION  309 

ing  worlds;  all  silent,  luminous,  immense,  swift-whirling,  yet  orderly. 
Happy  you  if  you  can  induce  a  bit  of  star  feeling  within  you! 

3.  Mountain.  Repeat  some  names  of  individuals  :  Mont  Blanc, 
Himalaya,  Orizaba,  Matterhorn,  Popocatepetl.  Get  your  mind  up 
among  the  noiseless  heights.  Let  the  serenity,  the  eternity  of  the 
words  filter  into  you. 

4.  Ocean.  Go  a-sailing,  out  of  sight  of  land.  Be  surrounded  for 
a  moment  by  waste,  wild  waters.  See  on  all  sides  only  horizon. 
Stand,  in  your  imagination,  by  the  seashore.  Hear  the  surf  boom. 
Do  not  talk.     Do  not  make  phrases.     Feel ! 

5.  Tree.  Call  to  mind  the  most  majestic  tree  you  know.  Touch 
its  rough  trunk.  Look  up  at  its  wide  branches.  Stand  from  it  and 
see  its  outline  against  the  sky.  Get  some  of  the  tree  feeling  into 
your  spirit.  Think  trees :  it's  a  wonderful  relief  from  thinking  dishes 
and  dustrags. 

6.  Dawn.  Think  of  sunrise,  of  the  freshness  of  life,  of  hopeful 
beginnings.    Induce,  if  you  can.  a  sense  of  sunrise. 

7.  More.  It  is  a  sonorous  word.  Repeat  it  —  slowly,  significantly, 
and  note  how  you  grow.     The  word  lifts  you  up,  expands  you. 

Don't  try  to  argue.  Just  say  these  seven  words.  Let  them  boom 
across  your  consciousness.  Somehow  they  will  still  and  banish  your 
littleness.  You  will  come  to  a  great  calm.  You  will  have  a  sense  of 
poise.  You  will  get  a  sense  of  remoteness  from  affairs.  You  can- 
not describe  it,  nor  impart  it.     It  is  a  secret. 

Your  self-contempt  will  vanish.  You  will  cease  to  think  yourself 
a  nothing,  a  puppet  insignificant.  You  will  feel  that  you  are,  deep  in 
your  hidden  life,  great  and  strong  and  wonderful.  For  who  can 
think  such  thoughts  and  be  wholly  little  and  contemptible? 

PSYCHIC    CONTAGION 

When  a  large  number  of  susceptible  individuals  are  exposed 
to  a  strong  suggestion,  there  sometimes  occurs  a  veritable 
epidemic  of  imitation  —  psychic  contagion.  Erratic  individuals 
are  sometimes  able  to  inculate  their  absurd  notions  into  the 
heads  of  scores  of  apparently  sane  individuals  who  will  follow 
them  to  any  foolish  length.  Minor  traits  of  character,  pecul- 
iarities of  disposition  and  eccentricities  of  temperament  are 
observed  to  go  through  entire  families  and  even  neighborhoods. 
Of  course,  in  the  case  of  this  family  resemblance,  heredity  may 
play  some  part,  but  psychic  contagion  is  the  chief  factor  in  most 
instances.     Epidemics  of  St.  Vitus'  Dance  have  been  traced  to 


310  WORRY  AND  NERVOUSNESS 

suggestion;  coughing,  sighing,  yawning,  all  lend  themselves 
readily  to  suggestion,  as  do  laughing  and  crying,  in  fact,  all 
forms  of  emotion.  Psychic  contagion  is  further  shown  in  the 
expectoration  habits  of  men.  Tobacco  chewing  is  going  out  of 
fashion,  but  still  men  remain  incessant  spitters.  Why  should 
men  spit  more  than  women  ?  Habit  is  the  answer,  and  psychic 
contagion  is  the  explanation. 

Imitation  is  far-reaching  in  its  influence,  dominating  our 
clothes  fashions,  as  well  as  accounting  for  the  numerous  crazes 
that  attack  society  from  time  to  time,  as  typified  in  the  bicycle 
craze,  roller  skating;  and  even  suicidal  tendencies  rise  and  fall 
in  accordance  with  newspaper  publicity.  Murders  of  a  particular 
kind  are  also  suggested  in  the  same  way,  and  "  waves  of  crime  " 
are  almost  annual  experiences  in  our  large  cities. 

Psychic  contagion,  or  the  psychology  of  the  mob,  may  also 
be  utilized  as  a  therapeutic  agent.  We  have  called  attention 
to  this  in  former  chapters  by  the  statement  that  neurasthenics 
and  neurotics  should  never  be  alone.  All  of  us  stand  fatigue 
better  in  a  crowd  than  when  we  are  alone.  You  can  walk 
twice  as  far  with  the  same  amount  of  weariness  on  a  cross 
country  tramp  in  congenial  society,  than  if  you  should  undertake 
a  solitary  journey  of  equal  distance.  Fire  panic  is  another 
case  of  psychic  contagion,  and  all  this  can  be  overcome  by  the 
fire  drills  such  as  are  conducted  in  the  public  schools.  In  fact, 
the  suggestion-power  of  newspapers  is  so  powerful  that  I  often 
find  it  necessary  temporarily,  to  stop  my  nervous  patients  from 
reading  the  daily  press. 

THE  CURATIVE  POWER  OF  SUGGESTION 

The  power  of  suggestion  is  immeasurable.  It  enters  into  our 
every  thought  and  act  of  life.  It  colors  every  sensation  and 
emotion  of  human  experience.  It  is  able  to  deceive  reason 
and  belittle  judgment,  and  creates  a  sort  of  continuous  panorama 
of  illusions,  which  we  are  forced  to  struggle  against  throughout 
a  life  time.  It  is  possible  to  generate  ideals  by  suggestions  and 
ideas  are  in  turn  able  to  create  feelings  and  sensations;  and 
there  is  absolutely  no  difference,  for  the  individual  who  experi- 
ences it,  between  the  painful  sensations  provoked  by  peripheral 


ART  OF  THERAPEUTIC  SUGGESTION  311 

irritation  and  those  which  result  from  a  central  excitation  — 
there  is  no  difference  to  you  between  a  real  pain  and  an  imagin- 
ary pain,  and  as  Dubois  has  said:  "Often  the  patient  does 
not  possess  any  criterion  by  which  to  decide  the  question,  and 
the  physician  himself  is  frequently  puzzled  over  its  settlement." 
As  an  illustration  of  the  power  of  suggestion  and  how  it 
becomes  necessary  sometimes  carefully  to  set  the  stage  in  order 
to  maintain  the  patient's  confidence  throughout  a  course  of  treat- 
ment, I  give  the  following  case:     Mrs.  D ,  married,  thirty 

six  years  of  age,  had  been  paralyzed  for  three  and  one-half 
years.  She  had  made  some  improvement,  but  not  enough  to 
enable  her  to  get  around  without  a  crutch  and  cane.  A  care- 
ful physical  examination,  including  that  of  the  nervous  system, 
showed  every  evidence  that  this  woman  was  not  paralyzed. 
Of  course,  it  was  impossible  to  say  that  she  had  not  been 
paralyzed  either  actually  or  hysterically  at  some  time  in  the 
past.  She  was  told  that  in  our  opinion  within  two  months,  ap- 
proximately, she  would  be  entirely  cured  and  would  be  able 
to  walk  without  crutch  or  cane ;  and  then  she  was  put  into  the 
Institute  to  undergo  a  course  of  treatment,  embracing  hydro- 
therapy, electricity,  massage,  etc.  In  connection  with  these 
physical  measures,  she  was  given  treatment  in  educational 
therapeutics  (in  this  particular  case  —  partly  on  the  "sug- 
gestive" order  —  twice  a  week)  and  it  is  interesting  to  note 
that  her  improvement  as  to  walking  ability  was  exactly  pro- 
portionate to  the  faith  and  hope  which  were  aroused  by  her 
psychic  treatment.  She  made  steady  improvement  and,  as 
was  promised,  she  was  fully  restored  and  able  to  walk  without 
crutch  or  cane  at  the  end  of  two  months'  treatment;  but  even 
to  this  day,  no  amount  of  argument  or  reasoning  will  convince 
her  that  she  was  not  paralyzed.  She  attributes  her  remarkable 
recovery  more  largely  to  the  physical  treatment  which  she 
received,  and  this  is  probably  due  to  the  fact  that  all  sorts 
of  mental  treatments,  healing  cults,  etc.,  had  been  tried  pre- 
vious to  her  coming  under  our  care,  and  all  had  proved  unsuc- 
cessful; and,  incidentally,  it  was  our  knowledge  of  the  failure 
of  all  these  methods  that  led  us  in  this  particular  case  care- 
fully to  arrange  a  course  of  physical  treatment  to  supplement  our 


3i2  WORRY  AND  NERVOUSNESS 

psychotherapeutic   efforts,   and   to   adopt   a   measure   of   "  sug- 
gestion "  in  addition  to  our  customary  regime  of  reeducation. 

FEAR  OF  POISONING 

The  power  of  suggestion  to  influence  the  functional  behavior 
of  a  patient's  circulation  is  shown  in  the  case  of  a  patient  I 
recently  had,  a  young  woman  of  neurotic  heredity,  twenty-two 
years  of  age,  who  believed  she  was  being  poisoned  in  some 
insidious  manner.  First,  she  thought  the  poison  was  put  in 
through  the  key  hole  into  her  bedroom,  and  she  worked  her- 
self up  into  a  hysterical  frenzy  over  this,  as  about  this  time  there 
was  a  great  deal  being  published  in  the  newspapers  about  white 
slavery,  the  needle  man,  etc.  Finally  after  being  persuaded 
that  this  could  not  possibly  be  true,  by  taking  her  to  the  hospital 
and  showing  her  how  long  it  took  and  how  many  ounces  of 
ether  were  necessary  to  narcotize  a  patient,  she  conceived  the 
idea  that  poison  was  being  put  in  through  the  water  tap  in  her 
room.  She  refused  to  either  drink  the  water  or  wash  in  it, 
and  finally  she  settled  upon  the  notion  that  poisonous  gas  was 
escaping  from  the  tap,  even  though  she  did  not  draw  the  water. 
This  sort  of  thing  went  on  for  about  a  year  and  a  half.  Then 
I  finally  made  ready  a  hypodermic  syringe,  in  the  water  of 
which  I  dissolved  a  very  small  amount  of  sugar  of  milk  from 
a  tablet  taken  from  a  bottle  on  my  desk,  telling  her  that  its  in- 
jection into  her  system  would  probably  markedly  affect  her 
heart,  but  not  to  worry,  that  it  was  a  necessary  procedure 
connected  with  her  cure. 

Immediately  upon  the  injection  of  the  harmless  solution  of 
sugar  of  milk,  her  heart  began  to  flutter,  she  became  dizzy,  her 
face  was  alternately  paled  and  flushed,  and  after  this  had 
continued  for  about  three  or  four  minutes,  I  opened  the  bottle 
of  sugar  of  milk  and  began  calmly  to  chew  up  the  tablets  and 
swallow  them  down  until  I  had  eaten  the  whole  bottle,  almost 
fifty  tablets.  Suffice  it  to  say  that  the  girl  had  brains  enough 
to  recognize  what  had  happened  and  as  far  as  I  know,  from 
that  day  to  this,  she  has  not  been  known  to  worry  about  subtle 
poisonings  or  needle  men.  Indirect  suggestion  sometimes  works 
more  quickly  than  direct  education. 


ART  OF  THERAPEUTIC  SUGGESTIOX  313 

THERAPEUTIC   MAXIMS 

In  the  battle  against  nerves,  the  successful  soldier  must 
learn  how  to  wrest  triumph  from  defeat;  must  learn  how  to 
"fight *it  out  along  this  line,  if  it  takes  all  summer."  The 
neurasthenic  must  encounter  his  difficulties  with  such  courage 
that  obstacles  will  only  serve  to  breed  the  spirit  of  indomitable 
conquest.  The  neurotic  soul  must  cheer  himself  on  in  the 
struggle  with  the  assurance  that  some  day  recovery  will  become 
automatic,  that  the  good  work  will  go  on  unconsciously  and 
without  constant  and  earnest  effort  on  his  part.  He  must  learn 
that  when  mental  discipline  and  self-control  have  been  practiced 
to  the  point  where  sixty  per  cent  or  more  of  his  mental  opera- 
tions are  normal  and  healthy,  then  the  balance  of  psychological 
gravity  will  be  all  on  the  side  of  sound  thinking  and  healthful 
impulses;  and  then  it  is  that  victory  begins  automatically  to 
perch  upon  his  torn  and  dusty  banner,  while  the  fight  from  this 
point  on  is  easily  and  surely  won. 

In  the  succession  of  battles  which  invariably  go  before  the 
final  victory,  we  have  found  it  very  helpful  to  put  in  the  hands 
of  our  patients,  as  was  suggested  by  Dr.  Walton,  certain 
phrases,  or  maxims,  which  the  nervous  patient  may  use  as  a  sort 
of  battle  cry,  to  cheer  him  on  when  the  struggle  grows  hard. 
Some  of  these  phrases  which  have  proved  helpful  to  our  pa- 
tients are  such  as  the  following:  "Hold  the  fort,"  "Never 
say  die,"  "  Sand  the  track,"  "  Play  ball,"  "  Saw  wood,"  "  Never 
give  up  the  ship,"  "  The  worst  is  over,"  "  I'll  get  there  yet." 
"Get  busy  — and  stick  to  it,"  "Play  the  game  square  and 
take  the  score  like  a  man,"  "  Never  touched  me." 

A  lot  of  good  is  being  done  in  the  world  by  hanging  up 
these  suggestive  mottoes  around  in  business  offices,  such  as  "  Do 
it  now,"  "  Keep  busy  to  keep  happy,"  "  Cheer  up,  the  less  you 
have  the  more  there  is  to  get."  and,  "  When  you  are  down  in 
the  mouth,  think  of  Jonah,  he  came  out  all  right." 

SUMMARY   OF   THE    CHAPTER 

1.  The  miracles  (so-called)  of  ancient  medicine  man  and 
modern  bogus  healer  are  alike  dependent  upon  suggestion. 

2.  The  practice  of  suggestion  does  not  necessarily  imply  the 


3i4  WORRY  AND  NERVOUSNESS 

employment  of  deception  and  subterfuge;  it  rather  embraces  the 
use  of  persuasion,  inspiration,  and  education. 

3.  The  science  of  suggestion  is  the  art  of  endowing  good  ideas 
with  a  new  power  that  will  enable  them  to  overthrow  their  mis- 
chief-making fellows. 

4.  In  suggestion,  good  ideas  are  supposed  to  grow  up  in  the 
sub-conscious  mind  until  they  are  sufficiently  mature  to  assert 
themselves  and  liberate  the  patient  from  the  tyranny  of  fear  and 
other  erroneous  beliefs. 

5.  Therapeutic  suggestions  may  be  either  true  or  false,  but 
only  the  true  make  for  permanent  results  and  complete  recovery. 

6.  Suggestion  as  a  remedy  is  as  old  as  the  hills  and  accounts 
for  the  fact  that  widely  differing  systems  of  healing  and  schools 
of  medicine  are  equally  efficacious  in  curing  disease. 

7.  The  ideal  method  of  treating  one's  difficulties  is  by  auto- 
suggestion. You  can  practice  mental  therapeutics  on  yourself 
just  as  well  as  to  employ  some  one  else  to  do  it  for  you. 

8.  Positive  thinking  as  well  as  opposite  thinking  is  essential 
to  success  in  mental  therapy. 

9.  A  lot  of  good  people  allow  their  own  minds  to  bluff  them. 
They  scare  themselves  out  of  success  and  into  certain  failure. 

10.  Worry  is  never  cured  by  resisting  it  as  such.  You  drive 
out  fear-thought  by  exercising  faith-thought. 

11.  It  is  a  calamity  to  form  the  habit  of  taking  yourself  too 
seriously.  The  world  does  not  regard  you  seriously,  why  should 
you  take  yourself  so  seriously? 

12.  The  art  of  self-ridicule  —  the  ability  to  see  the  funny  side 
of  your  own  nature  —  is  an  invaluable  health  practice. 

13.  Self-control  is  the  secret  of  curing  worry  and  banishing 
the  blues;  and  all  this  means  mental  discipline  with  increased 
will  power. 

14.  Make  a  declaration  of  emancipation.  Be  independent  of 
your  mental  moods,  physical  passions,  and  psychic  whims. 

15.  When  fighting  has  done  all  it  can,  learn  how  gracefully  to 
surrender  and  be  content  with  your  lot. 

16.  Practice  the  contemplation  of  great  things  and  great 
thoughts.  Spend  a  little  time  thinking  about  the  big  universe  you 
are  whirling  around  in. 

17.  Psychic  contagion  is  a  real  thing.  The  psychology  of  the 
mob  is  the  great  proof  of  the  power  of  collective  suggestion. 

18.  Epidemics  of  excitement,  nervous  disorders,  crimes,  and 
suicide  result  from  psychic  contagion  in  the  community. 

19.  Fads  in  dressing,  bicycling  and  roller-skating  are  the  result 
of  imitation  and  suggestion. 

20.  The  universal  reading  of  the  daily  press  contributes  power- 
fully to  psychic  contagion  in  the  community,  state,  and  nation. 


ART  OF  THERAPEUTIC  SUGGESTION  315 

21.  The  power  of  suggestion  is  immeasurable.  It  enters  into 
every  thought  and  act  of  life,  it  colors  every  sensation  and  emo- 
tion of  human  experience. 

22.  When  the  psychic  struggle  goes  hard,  it  is  highly  helpful  to 
have  some  battle  cry,  such  as  "  I'll  never  give  up  the  ship,"  and 
cling  tenaciously  to  it  until  the  crisis  is  passed. 


CHAPTER  XXV 
EDUCATIONAL  THERAPEUTICS 

UXDER  the  head  of  educational  therapeutics  we  desire  to 
discuss  those  prophylactic  and  curative  measures  repre- 
sented by  self-control,  self-discipline,  and  self-denial;  together 
with  the  formation  of  desirable  and  habitual  modes  of  thought 
and  action,  designed  to  take  the  place  of  those  uncontrolled  and 
disorganized  modes  of  thinking  and  acting  which  are  so  char- 
acteristic of  the  various  nervous  states. 

EARLY   SELF-DISCIPLINE 

It  is  desirable  to  start  out  in  the  child's  life  with  the  early 
inculcation  of  the  thought  that  the  one  great  thing  in  human 
education  is  self-control  —  self-mastery.  This  work  of  training 
must  begin  when  the  child  is  a  tiny,  crying,  struggling  infant  in 
its  crib.  It  must  be  taught  from  earliest  infancy  gracefully  to 
submit  to  emotional  discipline  and  reasonable  disappointment. 
It  must  be  taught  patience  —  to  remain  calm  in  the  presence  of 
a  disappointing  or  a  distasteful  situation. 

And  this  same  training  which  should  thus  be  so  early  inau- 
gurated must  be  kept  up  unrelentingly  throughout  the  long 
years  of  a  life  time,  for  the  men  or  women  who  have  not 
acquired,  or  who  will  not  acquire,  the  power  to  rule  their  own 
nerves,  govern  their  own  emotions,  and  control  their  own  feel- 
ings, if  the  training  requisite  to  this  degree  of  self-discipline 
has  not  been  undergone  by  the  patient,  must  know  that  there 
is  but  one  hope  for  the  future  —  such  undisciplined  minds  and 
unrestrained  nerves  must  continue  on,  the  victim  of  all  those 
annoying  and  distressing  symptoms  which  are  the  invariable 
accompaniment  of   ennui,  neurasthenia,   and  hysteria. 

MENTAL    CONCENTRATION 

In  practicing  concentration  it  is  necessary  to  aim  at  definite 
mental  obligation.    Take  up  the  study  of  mathematics  and  work 

316 


EDUCATIONAL  THERAPEUTICS  317 

on  the  solution  of  difficult  problems.  Carefully  read  a  page  in 
a  book  and  then  endeavor  to  write  a  resume  of  what  you  have 
read.  Listen  to  three  minutes'  conversation  and  then  endeavor 
fully  to  write  it  out  —  completely  reproduce  it.  Listen  to  a 
lecture  for  one  hour,  never  allow  your  eyes  to  leave  the  speaker, 
and  not  for  one  moment  permit  the  mind  to  wander  away  from 
what  you  are  hearing. 

When  practicing  in  this  way  at  concentrating  the  mind,  do 
not  become  discouraged  if  irrelevant  ideas  come  sneaking  into 
the  consciousness,  for  foreign  thoughts  will  certainly  thus  intrude 
themselves  upon  the  young  psychic  athlete,  but,  as  I  say,  do  not 
let  this  discourage  you.  Simply  dismiss  these  ideas  the  moment 
you  become  conscious  of  their  presence  in  the  mind,  and  quickly 
and  resolutely  switch  the  focus  of  attention  back  onto  the  sub- 
ject you  have  elected  to  concentrate  upon.  Many  failures  will 
come  before  success  is  achieved,  but  ultimate  success,  more  or 
less  complete,  will  surely  reward  all  those  who  persevere. 

THE  PHYSIOLOGY  OF  CONCENTRATION 

The  immediate  physiological  effects  of  successful  mental  con- 
centration are  very  striking.  When  the  mind  is  thus  focused 
upon  a  definite  idea  and  when  the  concentration  is  not  over- 
prolonged,  scores  of  nervous  physical  manifestations  are  more 
or  less  completely  removed.  The  physical  organism  quiets 
down,  numerous  functional  agitations  are  more  or  less  calmed, 
and  the  tortured  nerves  of  the  self-centered  individual  are 
permanently  relieved  of  that  oppressive  watchfulness  which 
is  so  constantly  exercised  by  the  neurotic  patient  over  the 
physical  behavior  of  his  own  organism. 

Dr.  Yittoz  even  claims  to  be  able  to  detect  the  difference  by 
the  sense  of  feeling  between  the  vibrations  which  emanate 
from  the  skull  when  the  mind  is  concentrated  in  the  one  case 
upon  the  thought  of  calmness  and  in  the  other  upon  the  thought 
of  energy.  While  it  is  not  for  me  to  say  what  another  physician 
can  feel,  I  am  impelled  to  record  at  this  time  that  I  have  never 
been  able  to  feel  such  vibrations,  and  I  have  met  few  other 
specialists  in  this  line  of  work  who  claim  to  have  been  suc- 
cessful   in   detecting   these    specialized   oscillations   proceeding 


318  WORRY  AND  NERVOUSNESS 

from  the  human  cranium.  But,  however  these  claims  may  ulti- 
mately develop,  there  is  no  disputing  the  fact  of  the  tremendous 
influence,  favorable  influence,  too,  upon  the  body  as  a  result 
of  concentrating  the  mind,  and  this  influence  extends  over  the 
vast  domain  of  the  entire  vasomotor  system.  It  also  markedly 
affects  all  of  the  internal  vital  organs,  as  is  so  well  illustrated 
in  the  case  of  certain  high-strung  nervous  people  who  will  be 
attacked  with  a  fit  of  indigestion  if  they  strongly  concentrate 
the  mind  immediately  after  eating.  Thus,  as  a  result  of  their 
unstable  circulation,  they  draw  too  much  blood  away  from 
the  digestive  tract  in  order  to  sustain  the  activities  of  the  brain. 

Concentration  of  the  mind  is  also  able  greatly  to  elevate  the 
threshold  of  the  consciousness  of  pain,  as  exemplified  in  the  case 
of  those  individuals  who  have  been  severely  injured  while 
the  mind  was  intently  occupied,  but  have  not  discovered  their 
injury  or  recognized  the  pain  resulting  therefrom  until  consider- 
able time  had  elapsed  —  until  the  concentration  of  the  mind 
was  relaxed. 

I  have  repeatedly  observed  that  in  the  case  of  certain  nervous 
patients  who  suffer  habitually  from  cold  hands  and  feet,  and 
whose  nervous  equilibrium  is  not  fully  destroyed,  they  are  able 
partially  or  wholly  to  cure  themselves  for  the  time  being  of 
cold  hands  and  feet  by  vigorous  concentration  of  the  mind 
on  those  portions  of  the  body  which  are  thus  deficient  in  circula- 
tion. Likewise  we  have  been  able  to  train  neurasthenics  and 
hysterics  almost  instantaneously  to  overcome  the  feeling  of 
numbness  which  is  so  commonly  present  in  some  part  of  the 
body  on  waking  up  in  the  morning.  Again,  we  have  been 
successful  in  many  cases  of  overcoming  excessive  blushing,  also 
excessive  flow  of  perspiration,  as  in  the  case  of  certain  nervous 
young  people  who  experience  these  annoying  symptoms  when 
appearing  at  social  gatherings  or  attempting  to  speak  in  public. 
In  these  cases  the  mind  is  trained  in  substitute  concentration  — 
to  concentrate  upon  a  certain  settled  idea  when  there  is  danger 
of  these  nervous  circulatory  symptoms  recurring. 

As  more  fully  shown  in  my  former  work,  the  heart,  lungs, 
stomach  and  intestines  are  all  directly  and  powerfully  influ- 
enced by  the  degree  in  which  the  mind  may  be  concentrated 


EDUCATIONAL  THERAPEUTICS  319 

upon  some  particular  physical  function,  and  to  the  extent  by 
which  the  intellect  is  dominated  by  the  basic  emotions  of  faith 
or  fear. 

In  connection  with  the  subject  of  the  concentration  of  the 
mind  upon  some  particular  part  of  the  body,  there  occurs  a 
very  peculiar  and  sometimes  paradoxical  phenomenon.  It  is 
this:  ordinarily,  when  suffering  from  a  pathological  or  imaginary 
functional  pain,  the  patient's  agonies  are  usually  increased  by 
allowing  the  mind  to  dwell  upon  the  pain;  but  in  the  case  of 
some  trivial  sensation,  such  as  pinching  the  arm,  for  example, 
the  abnormal  sensation  thus  induced  can  be  altogether  and  in- 
stantaneously wiped  out  by  powerfully  concentrating  the  mind 
upon  the  part  affected,  thus  inducing  an  immediate  flood  of 
healthy  and  centrally  controlled  impulses  to  sweep  over  the 
part  affected. 

PERSUADING    ME.x's    MINDS 

Tactful  persuasion  represents  the  shortest  possible  route  by 
which  one  .individual  can  get  an  idea  into  the  head  of  another 
individual.  When  the  patient  once  has  confidence  in  his  physi- 
cian, we  are  able  to  make  our  greatest  and  most  rapid  strides 
along  the  lines  of  educational  therapeutics  by  means  of  discreet 
and  sincere  persuasion.  To  cure  a  psychic  disorder  by  recourse 
to  authority  or  any  other  method  other  than  the  enlightenment 
of  the  patient's  mind,  the  arousal  of  his  judgment,  the  satis- 
faction of  his  reason,  and  the  strengthening  of  his  will,  will  be 
found  a  deception  in  the  end.  If  the  patient's  mind  is  suffi- 
ciently aroused  and  his  enthusiasm  enlisted,  he  will  lay  the  hand 
of  auto-authority  upon  his  own  brain  and  something  new 
under  the  sun  will  begin  immediately  to  happen  in  his  mind; 
and  thus  we  have  secured  obedience  to  our  treatment  and  cura- 
tive results  are  sure  to  follow  without  our  having  stultified  in 
the  least  the  clear-sightedness  of  the  patient. 

A  great  many  patients  who  are  supposed  to  be  in  need  of 
more  will-power  are  really  in  possession  of  a  sufficient  amount  of 
that  particular  article,  but  what  they  do  need  is  intelligence  — 
the  ability  immediately  and  economically  to  use  their  will- 
power—not to  say  that  they  also  frequently  stand  in  need  of 


320  WORRY  AND  NERVOUSNESS 

proper  encouragement  and  inspiration.  It  was  Spinoza,  I  think, 
who  said:  "Intelligence  and  will  are  but  one  and  the  same 
thing." 

And  in  this  connection  we  must  also  recognize  a  special 
sphere  of  intelligence  which  might  very  properly  be  called 
"  moral  intelligence."  Today  training  schools  are  needed  where 
moral  intelligence,  the  discriminating  analysis  of  life's  prob- 
lems, could  be  taught.  Perhaps  the  church  should  fulfill  this 
function,  but  it  has  certainly  fallen  a  great  way  behind  in  the 
fulfillment  of  its  functions  in  this  regard. 

While  educational  persuasion  is  at  present  the  more  ideal 
method  of  practicing  psychotherapy,  still  we  must  not  despise 
the  time-honored  and  lowly  art  of  suggestion.  There  are 
many  patients  whom  you  cannot  at  first  directly  teach,  but  to 
whom  you  can  indirectly  suggest.  For  instance,  I  recently  had 
a  patient  who  indulged  in  an  incessant  nervous  hacking  cough. 
I  reasoned  with  him  for  weeks,  told  him  of  its  effect  upon  his 
lungs,  his  health,  his  nerves,  and  bye  and  bye  I  literally  per- 
suaded him  —  educated  him  —  out  of  this  cough,  and  he  is  cured 
today.  That  was  ideal  psychotherapy.  But  I  recently  read  the 
story  of  a  boy,  just  a  young  chap,  who  also  had  a  nervous 
cough.  No  amount  of  admonition  or  persuasion  had  been  able 
to  cure  him.  While  out  in  the  street  one  day,  one  of  his  play- 
mates, probably  equally  nervous,  became  disgusted  with  the  boy's 
constant  coughing  and  said  to  him:  "If  you  don't  stop  that 
coughing,  I'm  going  to  punch  the  daylights  out  of  you."  Of 
course,  the  mere  suggestion  of  coughing  was  enough  to  attract 
the  little  fellow's  attention  and  he  proceeded  immediately  to 
cough  again,  whereupon  the  other  boy  fulfilled  his  threat.  He 
punched  him  unmercifully,  but  the  lad  was  never  known  again 
to  yield  to  his  impulse  of  nervous  coughing.  You  see  his 
experience  suggested  to  his  mind  the  substitution  of  the  fear 
of  being  "  punched  "  in  the  place  of  his  cough  fear. 

PERSUASION    VS.    ARGUMENT 

Some  patients  may  progress  along  these  educational  lines  very 
slowly ;  they  are  therapeutic  "  doubting  Thomases."  They  will 
argue  protractedly  to  prove  the  incurability  of  their  cases  — 


EDUCATIONAL  THERAPEUTICS  321 

provided  their  physician  is  foolish  enough  to  argue  with  them. 
They  faithfully  follow  all  his  treatment  orders,  but  they  are 
devoid  of  enthusiasm.  Their  faith  is  not  of  the  order  which 
moves  mountains.  But  we  do  not  become  discouraged  with 
patients  of  this  sort,  for  when  they  are  once  cured  by  proper 
educational  methods  and  the  exaltation  of  the  will  to  its  rightful 
place  of  power  in  the  psychic  domain  —  they  usually  stay  cured 
for  a  lifetime. 

We  have  to  be  sympathetic  with  these  patients,  and  often  tell 
them  we  can  hardly  blame  them  for  looking  at  things  as  they 
do,  but  always  assure  them  that  as  physicians  we  look  at  these 
matters  differently,  that  we  can  come  more  nearly  seeing  the 
end  from  the  beginning  than  can  the  patient,  and  then  by 
steady  control  keep  their  trolleys  on  the  treatment  wire  until 
at  a  later  time  they  begin  to  discover  real  evidences  of  a 
cure. 

One  of  the  most  fatal  notions  is  for  the  neurasthenic  patient 
to  get  it  into  his  head  that  he  has  two  diseases  —  his  nervous 
condition  —  and  then  some  possible  organic  disease  in  addition. 
I  dislike  very  much  to  be  forced  to  tell  a  patient  that  they  are 
suffering  from  some  organic  disease  until  I  have  first  won  the 
fight  with  their  functional  nervous  disorder.  I  am,  therefore 
(unless  it  is  a  grave  and  seemingly  incurable  disorder)  given 
to  passing  over  the  diagnosis  as  far  as  possible  in  such  cases 
and  achieving  my  purpose  by  making  a  frank  and  favorable 
prognosis  as  far  as  the  facts  will  warrant  me.  In  this  way 
we  can  avoid  the  pitfalls  of  a  lukewarm  diagnosis  and  aid  our 
psychotherapy  by  means  of  a  strong,  hearty,  entirely  consistent 
and  altogether  likely  prognosis. 

MEMORY  DISORDERS 

It  is  a  common  complaint  on  the  part  of  nervous  patients 
that  they  are  fast  losing  their  memories.  They  especially 
complain  of  inability  to  remember  the  names  of  people,  as  well 
as  being  unable  quickly  to  call  to  the  mind  certain  words  and 
otherwise  to  remember  facts  and  dates,  all  of  which  they  are 
familiar  with.  It  is  necessary  carefully  to  teach  these  patients 
that  these  disorders  of  memory  are  not  permanent,  that  they  are 


322  WORRY  AND  NERVOUSNESS 

in  no  wise  evidence  of  failing  mentality,  that  they  are  but 
the  common  everyday  accompaniments  —  well  recognized  and 
thoroughly  understood  symptoms  —  of  the  functional  nervous 
disorders  from  which  they  are  suffering.  If  these  patients  can 
be  induced  to  take  their  minds  off  themselves,  their  chances  of 
cure  will  greatly  improve  and  the  memory  faculties  will  have 
an  opportunity  to  devote  themselves  to  subjects  other  than  the 
constant  consciousness  of  one's  own  sensations  and  sufferings. 
Then,  too,  it  should  be  remembered  that  over-anxiety  in  our 
efforts  to  remember  always  interferes  with  our  power  to  recall 
our  memory  images.  The  strength  of  memory  is  always  in 
direct  proportion  to  the  intensity  of  attention,  and  the  power  of 
attention  is  always  greatly  disordered  and  decreased  in  neuras- 
thenics. 

Fatigue,  real  or  imaginary,  always  tends  to  interfere  with  the 
keenness  of  memory.  It  is  common  for  business  men  to  con- 
fuse lack  of  attention  with  loss  of  memory,  and  thus  come  to 
regard  themselves  as  suffering  from  the  latter  when  their 
troubles  are  wholly  due  to  the  fact  that  they  are  giving 
but  slight  attention  to  the  details  of  their  business  as  a  result 
of  lack  of  mental  concentration,  and  so  they  come  to  find  that 
they  are  not  in  possession  of  the  full  facts  respecting  their 
affairs  which  they  formerly  held  in  their  minds,  and  in  this 
way  they  are  tricked  into  believing  that  the  memory  is  failing. 

MEMORY    TRAINING 

A  great  deal  can  be  done  to  re-train  a  neurasthenic's  memory, 
and  in  reference  to  this  point  Walsh  says: 

My  rule  now  is  to  tell  patients  who  come  complaining  of  loss  of 
memory  that  if  there  is  any  real  loss  of  memory  it  is  due  to  their 
improper  use  of  the  faculty,  or  perhaps  to  their  failure  to  exercise  it 
sufficiently,  for  the  proper  performance  of  function  depends  on 
adequate  exercise.  They  are  then  instructed  to  take  certain  simple 
classical  bits  of  literature  and  commit  them  to  memory.  At  the 
beginning  such  short  poems,  with  frequently  repeated  rhymes,  of  the 
modern  poets  as  are  comparatively  easy  to  learn  are  set  as  memory 
exercises.  Later  Goldsmith's  "  Traveler,"  and  "  Deserted  Village," 
are  suggested.    Then  passages  from  Shakespeare  are  given.    Just  as 


EDUCATIOXAL  THERAPEUTICS  323 

soon  as  the  patient  finds  that  he  can  commit  to  memory  as  he  used 
to,  if  he  only  gives  himself  to  the  task,  a  change  comes  over  his 
ideas  with  regard  to  the  loss  of  memory.  For  many  of  these  people 
the  occupation  of  mind  is  an  excellent  therapeutic  measure.  Be- 
sides, selections  can  be  made  in  such  a  way  as  to  keep  before  their 
minds  the  thoughts  they  most  need  in  the  shape  of  memory  lessons. 
It  is  a  discipline  of  memory'  that  revives  it  and  also  a  constant  exer- 
cise in  favorable  suggestion. 

DISCOUNTING    YOUR    FEARS 

It  is  a  good  habit  to  form,  systematically  and  persistently, 
the  practice  of  sensation-neglect,  if  the  causes  of  your  worry  are 
certain  physical  conditions.  If  your  worries  are  of  a  moral  or  a 
family  nature,  make  your  peace  with  God  and  your  fellow-men, 
and  then  practice  a  little  common  sense.  The  employment  of  a 
great  and  good  motive  will  do  a  great  deal  to  drive  worry  out 
of  your  experience. 

The  majority  of  our  fears  and  many  of  our  sensations 
should  be  liberally  discounted.  We  should  not  form  the  habit 
of  taking  our  emotions  and  feelings  too  seriously.  They  are 
very  liable  to  impose  upon  us,  unduly  to  alarm  and  frighten  us. 
Even  if  we  find  it  exceedingly  difficult  to  exercise  control  over 
our  own  fears  and  worries,  let  us  at  least  succeed  in  meeting 
the  fears  and  anxieties  of  our  associates  without  appropriating 
them  to  ourselves  or  otherwise  echoing  them. 

Another  illustration  of  how  easy  it  is  to  overestimate  the  value 
of  our  fears  and  apprehensions  is  shown  in  the  excitement 
and  consternation  which  prevail  in  some  homes  when  a  thunder- 
storm is  approaching,  especially  if  the  lightning  is  severe.  The 
mother  becomes  panic-stricken,  her  face  assumes  a  frightened 
expression,  and  she  begins  to  gather  the  children  around  her  in 
one  corner  of  the  room  —  or  maybe  in  a  closet  —  where  they 
pass  the  time  in  fear  and  trembling,  momentarily  expecting 
to  be  hurled  into  eternity  by  a  malicious  bolt  from  the  skies. 
And  so  from  infancy,  most  children  are  led  to  look  upon  the 
elemental  forces  of  nature  with  fear  and  terror,  when  they  might 
have  been  taught  the  beauties  and  grandeur  of  nature's  powers. 

Most  of  us  need  to  practice  the  art  of  minimizing  our  diffi- 
culties.   Do  not  look  at  vour  obstacles  with  a  magnifying  glass. 


324  WORRY  AND  NERVOUSNESS 

Make  up  your  mind  that  in  many  instances  you  will  be  able  to 
rise  triumphant  over  apparent  defeat  and  to  move  right  on  in 
the  even  tenor  of  your  way.  Do  not  become  greatly  disturbed 
by  the  little  ripples  of  life  which  pass  through  your  experi- 
ence from  day  to  day.  Practice  taking  your  own  good  advice 
and  all  the  suggestions  you  give  to  other  people  about  not  worry- 
ing.    Don't   forget  to  use  them  yourself. 

Begin  to  pin  your  worries  down  to  definite  facts.  Most 
of  our  difficulties  are  vague  and  indefinite.  Many  of  our  fears 
and  worries  are  wholly  imaginary.  Make  a  practice  of  writing 
down  in  black  and  white  the  objects  of  your  worry.  The  process 
of  writing  them  down  will  usually  disclose  their  absurdity  and 
assist  in  the  work  of  overcoming  them.  To  abandon  oneself 
to  one's  feelings  means  to  be  impulsive  and  to  compromise 
one's  own  happiness  and  that  of  others.  All  the  feelings  must 
therefore  be  submitted  to  the  criticism  of  the  reason.  You 
will  perhaps  say:  But  my  sentiments  and  feelings  are  all 
good.  How  then  do  you  know  that  they  are  all  good,  if  you 
have  not  submitted  them  to  a  judgment  by  the  help  of  your 


reason 


Dubois  says : 

From  the  first  days  of  existence  education  commences  —  education 
by  sensible  experience,  sensations  of  comfort  and  discomfort  due  to 
physical  causes :  heat,  cold,  sensory  impressions,  moderate  or  too 
strong  for  the  sensibility  of  the  nervous  system.  From  the  first  cry, 
these  sensations  have  an  influence  over  the  new-born  mentality,  and 
one  can  understand  how  a  succession  of  painful  impressions  may 
modify  the  character  of  the  child,  and  create  the  fretful  disposition 
that  one  so  often  finds  in  children  who  have  suffered  from  sickness 
or  ill  treatment;  the  mark  is  sometimes  indelible.  Who  is  to  say 
that  this  education  by  the  senses  does  not  begin  before  birth,  in  the 
maternal  womb,  where  the  fetus  may  already  find  conditions  un- 
favorable to  its  well-being,  and  experience  painful  impressions? 

THE    CULTIVATION    OF    HOPE 

One  of  the  greatest  means  of  inspiring  the  patient  with  the 
hope  that  he  will  get  well  is  the  practice  of  making  a  thorough- 
going   physical    examination    and    laboratory    research    before 


EDUCATIOXAL  THERAPEUTICS  325 

pronouncing  a  diagnosis.  In  this  way  it  is  possible  quite  cer- 
tainly to  differentiate  between  organic  disease  and  functional 
disorders,  and  thus  the  physician  is  in  a  position  to  offer  the 
patient  a  more  definite  and  positive  assurance  of  recovery. 

While  it  is  true  there  may  be  more  or  less  of  an  element  of 
suggestion  in  this  procedure,  nevertheless,  it  is  suggestion  of  the 
highest  and  most  legitimate  order.  While  there  is  an  element 
of  faith  in  the  help  which  the  patient  gets  as  a  result  of  these 
thorough-going  investigations,  nevertheless,  it  is  faith  and  con- 
viction based  on  reason  and  not  the  blind  faith  that  is  sometimes 
appealed  to  by  those  remedial  measures  which  are  simply  and 
exclusively  suggestive.  There  is  a  great  difference  in  the  faith 
which  the  patient  may  have  in  his  physician  merely  as  a  healer 
and  the  faith  which  results  from  the  clear  exposition  and 
lucid  explanation  of  the  patient's  difficulties,  and  which  is 
able  to  win  his  confidence  and  secure  his  hearty  therapeutic 
cooperation. 

In  dealing  with  the  psycho-neuroses,  the  physician  must  be 
doubly  certain  of  his  grounds  —  must  be  reasonably  sure  of  his 
diagnosis  —  before  he  should  dare  to  speak  the  healing  mandate, 
"  You  will  surely  get  well."  This  is  serious  business  for  the 
conscientious  physician  and  it  is  due  to  the  fact  that  he  is  so 
seldom  in  position  honestly  to  utter  these  magic  words  that  so 
many  patients  of  this  order  are  cured  by  the  irregular  and 
unscrupulous  practitioners  who  do  not  hesitate  to  guarantee 
cures. 

THE   PRACTICE  OF  GOOD   EMOTIONS 

It  is  possible  for  a  nervous  patient  whose  experience  is  cursed 
with  a  flood  of  unhealthy  emotions  to  set  about  successfully  to 
create  good  emotions  —  to  master  the  art  of  practicing  desirable 
emotional  experiences.  These  mental  powers  are  all  subject 
to  cultivation  by  exercise  just  as  literally  as  are  the  material 
muscles.  Use  strengthens  and  practice  increases  mental  energy 
as  truly  as  it  does  muscular  power. 

It  is  a  good  practice  for  neurotics  to  learn  to  live  but  one  day 
at  a  time.  At  any  moment  in  their  life  some  unfortunate 
neurasthenics  are  suffering  from  all  the  troubles  they  ever  had, 


326  WORRY  AND  NERVOUSNESS 

all  they  now  have  and  all  they  think  they  ever  will  have.  If  you 
are  nervous  you  must  learn  that  "  sufficient  unto  the  day  is  the 
evil  thereof." 

There  is  a  great  educational  work  which  the  victims  of  worry 
can  carry  on  in  their  own  behalf.  They  can  modify  their  emo- 
tional behavior,  correct  and  retrain  their  faulty  mental  habits, 
and  in  many  other  ways  take  the  distressing  sting  out  of  their 
chronic  habits  of  fretting  and  worry.  The  larger  part  of  so- 
called  nervousness  is  nothing  more  or  less  than  faulty  nerve 
control  and  defective  thinking. 

It  is  sometimes  necessary  to  change  one's  position,  to  seek  new 
associations,  and  even  to  go  in  quest  of  new  scenery,  in  order 
to  be  able  to  get  control  of  one's  habits  of  thinking  when  they 
have  been  inordinately  deranged  by  some  sudden  shock  or  other 
distressing  experience.  On  the  other  hand,  it  is  entirely  possible 
for  the  average  patient  to  sit  right  down  where  he  is  and  begin 
the  work  of  capturing,  corralling,  and  reeducating  his  haphazard 
methods  of  thinking  and  his  unruly  nervous  mechanism.  The 
most  important  thing  is  that  you  should  be  willing  to  see  your- 
self as  you  are;  when  you  read  these  pages  and  recognize  your 
own  nervous  shortcomings,  apply  this  advice  with  the  same 
willingness  and  alacrity  which  you  exhibit  in  discerning  the 
description  of  your  neighbor's  ailments. 

If  you  really  make  up  your  mind  to  do  the  thing  —  to  use  a 
phrase  of  the  street  "get  busy"  —  then  you  will  find  the 
obstacles  and  difficulties  are  only  an  added  challenge  which 
increases  your  zest  for  the  game  and  whets  your  appetite  in 
anticipation  of  final  victory. 

THE  ART  OF  LIVING  EASY 

The  acme  of  success  in  nerve  training  is  to  acquire  the 
beautiful  art  of  living  easy  —  not  necessarily  easy  living  —  but 
that  beautiful  experience,  that  graceful  experience,  which  char- 
acterizes the  self-possessed  yet  unconscious  soul;  that  power  and 
poise  of  personality  which,  as  far  as  one's  own  mental  domain  is 
concerned,  makes  the  individual  master  of  all  he  surveys. 

These  are  the  patients  that  have  learned  how  to  laugh,  have 
acquired  the  art  of  living  with  themselves  as  they  are  and  the 


EDUCATIONAL  THERAPEUTICS  327 

world  as  it  is.  They  have  habitually  cultivated  the  smile  until 
it  has  become  perpetually  theirs.  They  have  mastered  the  art  of 
consuming  their  own  smoke  and  thus  clarifying  the  psychic 
atmosphere  in  which  they  think  and  move  and  have  their  being. 

Above  all,  the  physician  who  treats  nervous  patients  should 
never  be  hurried  —  or,  at  least,  never  appear  to  be.  The  doctor 
who  blows  in  like  a  gust  of  wind,  looks  at  his  watch,  and  speaks 
of  his  many  engagements,  is  not  qualified  to  practice  psycho- 
therapy. It  is  necessary,  on  the  contrary,  that  the  patient  should 
have  the  impression  that  he  is  the  only  person  in  all  the  world 
in  whom  the  physician  is  interested  just  at  this  time. 

Dr.  Cabot  has  arrived  at  the  conclusion  that  there  are  but 
four  essentials  to  the  real  enjoyment  of  life.  These  he  calls 
work,  play,  love,  and  worship.  Work  provides  activity  and  a 
mission  for  the  body  and  in  a  measure  occupies  the  mind.  Play 
is  the  means  of  relaxation  to  the  body  and  recreation  to  the 
mind.  It  affords  relief  from  the  depression  of  monotony.  Love 
fascinates  the  mind  and  gives  expression  and  satisfaction  to  the 
innate  and  instinctive  social  longings  of  human  beings ;  while 
worship  is  the  outlet  and  means  of  expression  of  the  higher 
spiritual  nature  which  in  some  form  or  other  resides  in  every 
human  being. 

SUMMARY    OF   THE    CHAPTER 

1.  Educational  therapeutics  embraces  those  prophylactic  and 
curative  measures  employed  in  mental  medicine,  ordinarily 
known  as  self-control,  self-denial,  and  self-discipline. 

2.  The  discipline  of  the  nervous  system  should  begin  in  earliest 
infancy,  and  be  kept  up  throughout  a  lifetime. 

3.  Nervous  patients  must  practice  and  acquire  mental  concen- 
tration. They  should  set  their  minds  at  work  in  the  performance 
of  definite  mental  tasks. 

4.  The  power  to  concentrate  one's  mind  is  not  readily  acquired, 
but  perseverance  will  always  bring  success. 

5.  Profound  mental  concentration  is  always  accompanied  by 
definite  physiological  effects  and  bodily  reactions. 

6.  Sensations  of  pain  and  other  physical  feelings,  together 
with  the  behavior  of  internal  organs,  are  all  more  or  less  in- 
fluenced by  vigorous  mental  concentration. 

7.  Mental  concentration  may  be  so  utilized  as  to  either  in- 
crease or  decrease  various  bodily  feelings  and  sensations. 


328  WORRY  AND  NERVOUSNESS 

8.  The  heart,  lungs,  stomach,  and  bowels  are  all  directly  in- 
fluenced by  the  intensity  and  degree  of  mind  concentration. 

9.  Tactful  persuasion  represents  the  shortest  possible  route  by 
which  one  individual  can  get  an  idea  into  the  mind  of  another. 

10.  Many  patients  who  seem  to  lack  will-power  in  reality  lack 
intelligence  —  the  ability  to  utilize  their  mental  powers. 

11.  In  psychotherapy,  methods  of  persuasion  should  always 
take  precedence  over  argument;  reasoning  is  always  helpful  but 
argument  is  fatal. 

12.  Sympathy  not  infrequently  keeps  the  physician  in  touch 
with  the  patient  until  reason  and  will-power  can  effect  a  cure. 

13.  Disorders  of  memory  which  accompany  neurasthenics  are 
a  source  of  great  worry.  This  should  not  be  regarded  seriously 
and  can  usually  be  cured  by  proper  methods  of  memory  training. 

14.  Fatigue,  real  or  imaginary,  always  tends  to  interfere  with 
the  keenness  of  memory,  as  does  also  lack  of  attention. 

15.  Learn  to  overcome  your  fears,  practice  sensation  neglect. 
Don't  be  bluffed  by  your  emotions. 

16.  Practice  the  art  of  minimizing  your  difficulties.  Do  not 
look  at  your  obstacles  with  a  magnifying  glass. 

17.  Many  nervous  patients  are  helped  by  the  practice  of  writ- 
ing down  in  black  and  white  the  object  of  their  fears  and  worries, 
thus  subjecting  their  feelings  to  the  criticism  of  reason. 

18.  The  neurasthenic  must  assiduously  cultivate  hope.  He 
must  place  implicit  trust  in  the  physician's  promise  that  he  "  will 
surely  get  well." 

19.  Practice  the  cultivation  of  good  emotions  in  conjunction 
with  the  suppression  of  undesirable  feelings.  In  this  way  you 
can  radically  modify  your  emotional  behavior. 

20.  It  is  sometimes  necessary  to  change  one's  position,  associa- 
tions, and  even  seek  new  scenery,  as  an  aid  to  escaping  from 
unhealthy  emotions. 

21.  The  most  important  thing  in  the  battle  with  one's  emotions 
is  to  "  get  busy  "  and  stick  to  the  job  until  the  victory  is  gained. 

22.  Cultivate  the  art  of  living  easy  —  the  knack  of  getting 
along  with  yourself  as  you  are  and  the  world  as  it  is. 

23.  Forget  yourself  while  the  mind  is  kept  busy  with  the  essen- 
tials of  life :  work,  play,  love,  and  worship. 


CHAPTER  XXVI 
THE  EXALTATION  OF  THE  WILL 

IN  THE  practice  of  psychotherapy,  reeducation  must  be  recog- 
nized as  a  distinct  process  of  mental  training.  While  it  may 
include  the  valuable  and  powerful  elements  of  suggestion,  it  is, 
nevertheless,  dependent  for  its  success  upon  intelligent,  methodi- 
cal, and  persistent  educational  processes;  it  is  a  method  of 
reforming  the  patient's  habit  of  thought  respecting  himself,  his 
nervous  difficulties,  and  his  other  disorders. 

WILL  POWER 

In  the  practice  of  psychotherapy,  reeducation  is  nothing  more 
or  less  than  a  process  of  mental  re-formation ;  new  groups  of 
ideas  are  created,  and  by  persistent  repetition  are  forced  into 
positions  of  power  and  influence  in  the  scheme  of  mental  organi- 
zation. The  false  conclusions,  the  harmful  and  unhealthy  ideas 
and  groups  of  ideas,  are  forced  into  the  background,  while 
the  new  idea  becomes  enthroned  in  a  position  of  power  and 
authority. 

While  the  intensity  of  mental  action  is  greatest  in  the  central 
consciousness,  it  should  be  remembered  that  the  contents  of  the 
mind  —  the  number  of  association  groups,  etc.  —  is  greatly 
increased  as  we  go  out  toward  the  periphery,  the  marginal  con- 
sciousness. The  central  consciousness  is  concerned  with  a 
small  number  of  clear  and  vivid  thoughts,  while  the  marginal 
consciousness  is  occupied  with  an  almost  infinite  host  of 
thoughts  and  ideas,  all  of  which  are  more  or  less  hazy  and 
indefinite,  and  even  unconscious.  The  will  power  of  most  people 
is  comparatively  weak;  that  is,  there  exists  a  tremendous  dis- 
proportion between  the  high  degree  of  modern  intellectual  cul- 
ture and  the  humiliating  weakness  of  the  will  in  the  average 
man.  Self-mastery  is  not  the  crowning  virtue  of  the  age. 
Self-control  is  the  crying  need  of  the  hour. 

329 


330  WORRY  AND  NERVOUSNESS 

The  will  is  the  final  arbiter  of  choice.  It  holds  the  balance 
of  power  in  all  mental  operations.  Its  strength  determines 
whether  or  not  the  body  can  be  compelled  to  carry  out  the  orders 
of  the  mind.  The  man  with  the  strong  will  has  the  body  under 
control  of  his  own  mind.  The  man  with  a  weak  will  may  have 
a  mind  controlled  by  the  appetites  and  passions  of  the  body; 
while  one  with  a  diseased  will  may  find  himself  partially  or 
wholly  under  the  control  of  another  mind.  The  will  has  knowl- 
edge of  and  also  includes  all  mental  operations. 

The  will  represents  the  combined  spiritual,  mental,  and 
nervous  forces  brought  to  bear  upon  mind  and  body  to  direct 
them  in  the  channels  of  choice  and  conscientious  conviction. 
The  will  represents  the  supreme  conclusions — the  final  effort  of 
the  mind.  It  should  be  remembered  that  merely  wishing  is  not 
willing.     The  will  is  the  battle  ground  of  character  formation. 

The  will  is  not  a  distinct  mental  power  in  the  sense  that 
judgment,  reason,  memory,  etc.,  are  powers  of  the  mind.  The 
will  represents  to  the  mind  what  the  sum  total  does  to  the 
column  of  figures.  It  is  the  master-builder  of  character  and  the 
architect  of  eternal  destiny. 

MAX    A    RESPONSIBLE    BEING 

Man  is  not  a  mere  machine,  not  even  an  intelligent  machine. 
Machines  can  perform  only  the  work  for  which  they  are  con- 
structed, they  are  not  responsible.  Man  is  in  the  highest  sense 
responsible  for  his  acts  and  habits;  he  has  a  will  and  possesses 
the  power  of  choice.  The  majority  of  animals  are  quite 
dependent  on  their  instincts  and  on  the  stimuli  which  reach  their 
brains  from  the  sensory  nerves,  but  man  is  able  to  direct  himself 
according  to  the  choosing  of  his  own  will.  While  reason  may  be 
the  highest  act  of  the  mind  itself,  practical  experience  goes  to 
prove  the  reason,  in  fact  the  entire  mind,  is  ever  subservient  to 
that  mighty  sovereign  of  the  personality  —  the  will. 

We  may  rent  our  minds  for  a  consideration,  we  may  let  out 
our  intellects  for  hire,  but  no  man  ever  leases  his  will  to  another. 
The  will  is  inseparable  from  the  personality.  Reason  is  simply 
the  attorney-general  of  the  mind,  appearing  before  the  supreme 
court  of  the  will. 


THE  EX  ALT  ATI  OX  OF  THE  WILL  331 

Because  man  has  this  splendid  endowment  of  will,  he  at  once 
becomes  a  creature  of  personal  responsibility,  and  it  is  therefore 
incumbent  upon  him  to  exhibit  a  reasonable  degree  of  self- 
possession,  self-restraint,  and  self-control.  Again,  the  will 
appears  as  the  governor  of  the  rate  of  mental  activity.  The 
mind  with  a  weak  will  thinks  rapidly  and  superficially.  The 
strong  will  compels  deep,  deliberate,  and  logical  thought.  When 
the  mind  is  not  inhibited  by  the  will,  it  roams  about  aimlessly 
from  one  end  of  the  world  to  the  other.  It  resembles  a  horse 
which  has  thrown  its  rider.  Such  a  mind  soon  degenerates  to 
the  mere  animal  level  —  ever  changing  its  course  of  thought 
with  the  constantly  changing  nerve  impressions  which  are 
brought  to  the  brain  over  the  sensory  nervous  system.  It 
requires  downright  hard  work  —  constant  effort  —  to  keep  the 
mind  at  work  under  the  direction  of  the  will.  Without  constant 
supervision  by  the  will,  the  mind  wanders  aimlessly  in  the 
midst  of  the  pleasant  scenes  of  its  own  imagination.  And  it  is 
just  because  we  have  so  little  will-thought  that  most  of  the 
mental  energy  of  the  world  runs  to  waste,  and  all  classes  of 
society  are  overrun  with  idle  dreamers.  The  divine  gift  of 
mental  freedom  carries  the  penalty  of  moral  and  personal 
responsibility. 

CHARACTER  AND  CONSCIENCE 

Character  formation  represents  the  grand  and  sublime  purpose 
of  life,  and  character  formation  is  determined  by  our  every 
thought,  word,  and  action. 

The  formation  of  character  is  influenced  not  only  by  the 
process  of  thinking  carried  on  within  the  mind,  and  its  resultant 
physical  acts,  and  the  habits  thereby  formed,  but  also  by  the 
spiritual  powers  —  the  higher  moral  influences  to  which  the 
mind  of  man  is  subject,  in  contradistinction  to  the  mind  of 
the  animal. 

Man  has  a  conscience.  The  conscience  cannot  be  described 
as  a  separate  mental  power.  It  is  the  spiritual  or  moral  guide 
to  conduct  and  thought,  having  for  its  basis  our  hereditary  and 
acquired  mental  attitudes  and  moral  standards.  It  is  the  spirit- 
ual voice,  speaking  to  the  will.     The  conscience  is  man's  moral 


332  WORRY  AND  NERVOUSNESS 

instinct.  It  imparts  divine  dignity  to  the  man,  and  forever  dis- 
tinguishes him  from  the  animal. 

The  conscience  is  ever  subject  to  education,  and  therefore  it 
must  never  be  looked  upon  as  an  infallible  and  unerring  guide 
to  conduct.  The  heathen  is  just  as  conscientious  in  praying  to 
an  idol  as  the  Christian  is  in  worshiping  a  personal  God. 
The  devout  Hindoo  mother  is  just  as  conscientious  in  throwing 
her  innocent  babe  into  the  mouth  of  the  crocodile  as  is  the 
Christian  missionary  in  his  efforts  to  save  her  benighted  soul. 

And  so  we  must  recognize  that  man  is  a  spiritual  being  as  well 
as  an  intelligent  animal.  The  primitive  man  is  always  religious, 
he  universally  worships  something.  Absolute  irreligion  is  only 
the  product  of  artificial  training  and  miseducation.  The  spirit 
which  operates  upon  the  mind  of  man  constitutes  the  divine 
source  of  our  higher  emotions.  Judgment,  ofttimes  sponta- 
neously, determines  the  right  for  the  mind,  and  conscience 
prompts  the  will  to  order  the  execution  of  judgment's  decrees. 

IDEAS   AND  EMOTIONS 

A  great  many  of  our  psychic  difficulties  arise  from  a  failure 
properly  to  control  our  ideas  and  regulate  our  emotions.  Others 
fail  to  distinguish  between  their  ideas  and  their  emotions.  They 
experience  emotions,  and  then  in  their  confusion  are  led  to 
believe  that  they  had  really  formulated  an  idea,  when  they  had 
only  experienced  a  passing  emotion,  due  partially  to  transient 
disturbances  in  the  circulation.  The  power  of  emotions  for 
good  is  not  to  be  ignored,  but  they  become  a  dangerous  psychic 
influence  when  allowed  to  wield  the  balance  of  power  in  the 
mind.  It  is  very  easy  for  an  overpowering  emotion,  in  the 
presence  of  an  unusual  situation,  entirely  to  override  the  will, 
to  displace  reason  and  judgment,  literally  to  sweep  the  sufferer 
off  his  feet.  Strong  emotions  interfere  with  the  correct  inter- 
pretation of  sensations,  and  otherwise  have  a  tendency  to  dis- 
organize the  reasoning  power  of  the  mind  as  well  as  to  stam- 
pede the  judgment  and  the  will. 

THE   CONTROL   OF   EMOTION 

If  the  mind  is  not  carefully  organized,  and  the  thinking  con- 
ducted in  a  systematic  and  orderly  fashion,  the  emotions,  when 


THE  EXALT AT  IOX  OF  THE  WILL  333 

running  riot,  may  even  go  into  the  realm  of  memory  and  there 
pervert,  distort,  and  destroy  our  very  recollections  of  things. 
Emotions  excite  the  heart  to  increased  action,  and  in  a  variety 
of  ways  produce  an  extravagant  expenditure  of  vital  energy. 
This  is  probably  due  to  the  fact  that  when  strong  emotions  are 
experienced,  the  higher  nervous  centers,  so  to  speak,  take  it  for 
granted  that  the  body  will  be  thrown  into  more  or  less  violent 
sympathetic  action— they  anticipate  the  need  of  increased  circu- 
lation, and  at  once  start  the  machinery  going  at  increased  speed. 

Emotion  represents  a  very  intimate  interassociation  between 
the  mind  and  the  body.  The  man  who  would  acquire  a  high 
degree  of  self-control  must  begin  on  the  emotions.  Never  sup- 
press or  annihilate  them  —  rather  control  and  coordinate  them. 
Those  who  have  chronic  congestion  in  any  one  organ  of  the 
body,  those  who  suffer  chronically  from  cold  hands  and  feet  and 
pale  skins,  are  much  more  likely  than  others  to  become  victims 
of  violent  emotional  outbreaks.  To  balance  the  circulation  and 
purify  the  blood  will  greatly  aid  in  securing  control  of  the  emo- 
tions. If  the  emotions  are  not  controlled,  they  will  eventually 
evolve  into  veritable  psychic  desperadoes,  charging  around 
through  the  mind  in  disorderly  fashion,  utterly  destroying  the 
finer  sensibilities,  building  themselves  up  into  tyrannical  masters, 
swaying  the  mind  at  will,  and  utterly  supplanting  reason  and 
judgment. 

The  strong  mind  acts  slowly ;  the  weak  mind  acts  quickly,  on 
the  spur  of  the  moment.  Daydreaming  is  good  for  the  imagina- 
tion, and  is  a  pleasant  and  profitable  exercise  for  the  mind; 
nevertheless,  we  should  never  allow  the  creations  of  our  day- 
dreaming to  assume  control  of  the  intellectual  reins.  We  need 
to  cultivate  the  habit  of  reflection  — that  is,  of  thinking  before 
we  act.  The  acquirement  of  the  reflection  habit  would  save  us 
a  great  deal  of  unnecessary  suffering  and  sorrow.  By  reflection 
we  do  not  mean  study,  or  mere  thinking.  Study  leads  to 
knowledge,  but  reflection  is  manifested  in  action.  The  highest 
degree  of  reflection  is  possible  only  in  the  presence  of  a  high 
degree  of  will  power.  As  we  strengthen  the  will  by  reeducation, 
the  mind  will  have  a  better  opportunity  to  reflect,  and  then  our 
actions  will  become  better  ordered  and  controlled. 


334  WORRY  AND  NERVOUSNESS 

INTEREST  AND  ENTHUSIASM 

When  the  mind  is  normal  and  healthily  at  work,  it  needs 
little  of  our  help  in  the  work  of  concentration.  Partridge  has 
well  said :  "  When  interests  develop  normally,  the  mind  is 
trained  to  its  work  without  great  and  distressing  effort.  The 
properly  fed  mind  trains  itself,  and  the  prevailing  idea  of  disci- 
pline is  certainly  largely  wrong.  The  constant  effort  to  do  that 
which  is  difficult  in  order  to  train  the  mind,  or  to  keep  it  in 
trim,  is  for  the  most  part  mistaken  effort.  When  interest  is 
aroused,  there  is  no  problem  of  concentration.  The  difficulty  is 
rather  to  keep  the  mind  away  from  a  subject  than  to  direct  it 
to  it.  Mental  energy  is  wasted  to  a  degree  which  would  seem 
scandalous  if  its  value  were  estimated  in  dollars  and  cents,  and 
which  is  equaled  only  by  the  abandon  with  which  we  give  away 
and  waste  that  other  most  precious  gift  of  nature.  —  Time." 

DUBOIS'   VIEWS 

Regarding  the  therapeutics  of  will  training,  Dubois,  an  un- 
usually successful  practitioner  of  these  methods  —  indeed  a 
pioneer  in  their  use  —  says : 

As  a  practicing  physician,  I  began  before  the  experiments  at 
Nancy  to  influence  my  patients  by  bona-fide  persuasion.  The  study 
of  books  by  Bernheim  and  the  visit  I  paid  him  in  1888  made  me 
realize  the  power  of  hypnosis  and  of  suggestion.  I  was  amazed  by 
his  demonstrations,  and  for  a  few  months  I  even  made  use  of  his 
methods,  but  I  recognized  immediately  their  artificial  character,  and 
I  abandoned  them  to  strike  the  path  where  I  had  left  it,  the  path 
of  rational  psychotherapeutics.  I  know  well  how  Bernheim  avoids 
his  difficulties.  On  his  own  responsibility,  he  changes  the  sense  of 
words  and  defines  suggestion  according  to  what  idea  he  has  in  his 
head.  In  this  case,  it  is  very  evident  that  all  mental  therapeutics 
have  their  origin  in  suggestion  and  that  persuasion  is  only  a  particu- 
lar form  of  suggestion.  I  am  not  at  all  anxious  to  juggle  with  com- 
monplace symptoms  or  try  to  dissipate  a  semi-anesthesia  by  a 
transfer,  a  subterfuge  which  consists  in  misplacing  the  limits  of 
insensibility  by  suggestion.  I  wish,  on  the  contrary,  to  study  my 
patient,  discover  by  what  conscious  or  subconscious  autosuggestion 
he  produces  sufferings  or  anesthesias.  I  would  like  to  free  him  of 
his  autosuggestibility,  and  for  that  reason  I  do  not  think  it  is  a  good 


THE  EXALTATION  OF  THE  WILL  335 

plan  to  cultivate  his  suggestibility  or  credulity.  His  headache,  per- 
haps, will  last  longer ;  he  will  take  longer  to  lose  his  insomnia,  his 
insensibilities;  he  will  give  me  more  trouble  than  if  I  forced  some 
therapeutic  suggestions  into  his  head ;  but  he  will  become  reasonable, 
capable  of  mental  synthesis,  and  when  he  comes  out  of  the  clinic  he 
will  not  only  have  left  behind  a  morbid  suffering,  an  anesthesia,  and 
a  disorder  of  the  functions,  but  will  also  have  acquired  a  spirit  of 
resistance  which  will  reestablish  his  psychical  and  physical  equilib- 
rium, and  will  protect  him  against  relapse,  even  if  unfortunate 
circumstances  continue  to  introduce  those  specific  causes  which  gave 
birth  to  the  crisis.  And  now,  after  many  gropings,  these  ideas  are 
becoming  defined  and  we  are  entering  at  last  upon  an  era  of  truly 
rational  psychotherapy.  There  still  remain  many  battles  to  be 
fought,  not  only  with  the  obdurate  somatists,  but  even  among  the 
partizans  of  psychotherapy,  for  everyone  has  his  own  ideas  on  the 
subject.  Believers  in  "suggestion"  will  not  lay  down  their  arms, 
but  will  continue  to  attract  to  their  ranks  the  medical  men  who  do 
not  know  how  to  reflect  and  to  attain  to  a  higher  conception.  For 
some  time  yet  the  "  psychoanalysts  "  will  take  pride  in  the  superiority 
they  attribute  to  themselves,  believing,  as  they  do,  that  they  penetrate 
more  deeply  the  innermost  depths  of  the  human  mind,  which  draws 
its  existence  from  the  "  subconscious,"  according  to  them.  Let  us 
leave  all  these  susceptibilities  among  medical  men  and  scientists  to 
react  upon  each  other.  Something  always  comes  of  these  discussions 
and  it  is  by  passing  through  error  that  we  gain  the  truth. 

INVOLUNTARY   THINKING 

From  what  we  have  said  regarding  the  great  powers  of  the 
will,  the  reader  must  not  reach  the  conclusion  that  it  is  possible 
to  bring  one's  thoughts  into  a  machine-like  sort  of  subjection. 
There  will  always  remain  that  independent  spontaneity  in  the 
ebb  and  flow  of  the  thoughts  which  has  its  origin  in  the  diverse 
and  manifold  psychic  and  physical  stimuli  ever  playing  upon 
the  mind  and  body.    As  one  writer  has  so  well  stated : 

Man  strangely  deludes  himself  when  he  imagines  that  he  is  able 
to  think  what  he  wishes  and  of  what  he  wishes.  No  man,  however 
great  a  genius,  has  ever  had  a  personal  thought,  or  originated  an 
idea  in  his  august  brow.  Thought,  however  complicated  it  may  be, 
only  results  from  an  association  of  ideas  which  in  no  wise  suffers 
the  yoke  of  a  sovereign  will.    Our  thoughts  impose  themselves  upon 


336  WORRY  AND  NERVOUSNESS 

us,  and  succeed  each  other  in  our  minds,  without  our  being  able  to 
change  their  order,  drive  away  those  which  are  troublesome  or 
voluntarily  dwell  upon  those  which  please  us.  They  all  result  from 
fortuitous  stimuli,  physical  or  psychic,  coming  from  the  exterior,  and 
therefore  extrinsic  with  regard  to  our  inmost  ego,  even  when  this 
stimulation  has  its  seat  in  our  organism.  We  do  not  direct  our 
thought ;  it  is  the  stimulus  which  gives  birth  to  it.  The  ideas  which 
come  to  us  are  the  fruits  of  personal  experience,  of  that  which 
others  transmit  to  us  by  word  or  by  book,  by  all  the  means  of  ex- 
pression which  our  five  senses  give  us.  We  do  not  therefore  think  by 
ourselves  in  the  strict  sense  of  the  word;  we  assist,  I  venture  to 
say,  passively,  in  the  working  of  our  mental  kaleidoscope,  in  which 
the  pictures  succeed  one  another  under  the  influence  of  the  impetus 
received  from  without.  The  movement  provoked  continues  while 
we  are  awake  and  is  prolonged  in  sleep  in  the  form  of  dreams,  and 
we  are  no  more  able  to  check  this  continual  flow  of  thoughts  during 
the  day  than  during  the  night.  We  always  feel  ourselves  to  be 
active,  and  not  passive  in  work  of  any  kind,  whether  it  be  a  fugitive 
thought  revealing  itself  by  a  gesture,  or  in  continuous,  persevering 
work.  We  are  free  in  the  crude  sense  that  the  public  give  to  this 
word ;  philosophically  speaking,  we  are  slaves  of  the  motives  which 
obtrude  themselves  upon  us  by  reason  of  our  character. 

METHOD    OF    PRACTICING    REEDUCATION 

More  or  less  psychanalysis  must  precede  the  successful 
practice  of  psychic  reeducation.  It  will  not  be  necessary  here  to 
repeat  the  principles  underlying  psychanalysis,  or  mental  diag- 
nosis. After  having  carefully  examined  the  mind  of  the  patient 
and  having  arrived  at  a  diagnosis  of  the  underlying  causes  of  his 
nervous  disorders  and  psychic  difficulties,  the  method  to  be  pur- 
sued in  the  process  of  reeducating  the  patient's  mind  and 
strengthening  the  will  may  be  summarized  as  follows: 

i.  Make  sure  that  you  have  not  overlooked  any  physical  con- 
dition or  bodily  disease  which  may  be  acting  as  a  contributing 
cause  in  these  mental  disturbances  or  nervous  disorders.  See 
that  digestion,  circulation,  metabolism,  and  elimination  are  pro- 
ceeding normally. 

2.  One  of  the  best  methods  of  arriving  quickly  at  a  mental 
diagnosis  is  to  allow  the  patient  to  tell  his  story  —  talk  it  all  out. 
It  is  the  author's  practice,  after  getting  pleasantly  settled  in  the 


THE  EXALTATION  OF  THE  WILL  ZZ7 

office  and  becoming  fairly  well  acquainted  with  the  patient,  to 
start  him  on  his  story  and  never  to  interrupt,  never  to  ask  a 
single  question,  until  he  has  finished  talking.  We  had  a  patient, 
a  nervous  woman,  who  talked  of  herself  this  way  for  an  hour 
and  a  half;  made  up  her  mind  she  was  the  ''biggest  fool  in 
town  " ;  analyzed  the  cause  of  her  difficulty,  and  within  six  weeks 
had  practiced  reeducation  and  autosuggestion  on  herself  to 
the  point  where  she  was  completely  restored.  It  was  one  of 
the  most  successful  and  remarkable  cases  the  author  has  ever 
met. 

3.  After  the  patient's  story  is  told,  arrive  at  just  as  accurate 
a  diagnosis  as  possible  respecting  the  false  methods  of  reasoning 
and  the  erroneous  conclusions  which  have  led  him  into  this 
neurotic  condition.  It  is  absolutely  necessary  that  the  definite 
ideas,  emotions,  and  false  conclusions  shall  be  isolated,  prepara- 
tory to  the  successful  employment  of  reeducation. 

4.  Xow  that  the  examination  and  diagnosis  are  completed, 
the  time  has  come  for  reeducational  therapeutics.  Begin  at 
once  to  point  out  to  the  patient  the  exact  error  in  the  working 
of  the  mental  machinery.  Explain  simply,  fully,  and  specifically 
wherein  the  trouble  lies.  Be  methodic  and  positive  as  far  as 
you  are  conversant  with  the  case.  Explain  things  to  the  patient 
honestly,  frankly,  and  fully,  just  as  they  appear  to  you.  Lay 
aside  all  this  nonsense  about  laymen  not  being  able  to  under- 
stand their  diseases.  If  explained  in  plain  English,  it  is  the 
author's  experience  that  most  patients  are  able  to  understand 
their  difficulties  just  about  as  well  as  a  physician.  Endeavor 
to  make  a  logical,  full,  and  rational  presentation  of  the  whole 
thing  to  the  patient's  mind,  just  as  it  appears  to  you. 

5.  The  next  essential  step,  having  laid  matters  before  these 
nervous  patients,  is  to  secure  their  full  confidence  and  hearty 
cooperation ;  and  then  day  by  day  and  week  by  week  continue 
that  persistent,  systematic,  and  methodical  work  of  repeating 
this  story,  building  it  up,  developing  it  and  adding  to  it  from 
time  to  time,  until  the  new  teaching  comes  to  occupy  the  center 
of  the  stage  and  effectually  drive  the  old  and  false  ideas  into  the 
background. 

6.  It  is  highly  important  that  these  nervous  patients  should 


338  WORRY  AXD  NERVOUSNESS 

specifically  recognize  wherein  their  former  mental  habits  (their 
old  ways  of  looking  at  things)  were  wrong.  It  is  highly  essen- 
tial that  they  should  individually  recognize  their  mistakes  and 
acknowledge  them,  for  in  these  cases  confession  is  good  for  the 
soul.  See  to  it  that  their  false  ideas  of  disease  are  cast  out  of 
the  mind.  Make  them  definitely  promise  to  work  with  you 
toward  the  development  of  the  new  and  right  ideas. 

THE   RANGE  OF  REEDUCATION 

It  will  readily  appear  that  the  practice  of  this  method  of 
psychotherapy  requires  no  unusual  skill,  no  extraordinary  knowl- 
edge, not  even  special  knowledge  respecting  psychology  on  the 
part  of  the  practitioner.  It  is  entirely  possible  for  certain  people 
who  have  awakened  to  a  recognition  of  their  psychic  condition 
to  practice  this  method  upon  themselves ;  in  which  case  it  would, 
of  course,  partake  largely  of  the  nature  of  autosuggestion. 
Any  physician  can  practice  this  method  upon  his  patients;  any 
intelligent  parent  can  utilize  it  in  child  culture;  any  wide-awake 
teacher  can  use  it  in  the  work  of  teaching.  And  herein  lies 
its  greatest  power ;  that  is,  it  is  practical  and  entirely  free  from 
deception,  sophistry,  and  delusion.  This  method  is  certainly  the 
most  simple,  and  at  the  same  time  the  most  successful,  of  all  the 
procedures  of  modern  psychotherapy. 

This  method  of  reeducation  may  be  used  on  a  large  range  of 
worried,  nervous,  so-called  neurotic  patients.  It  demands 
neither  hypnosis  nor  suggestion,  as  those  terms  are  ordinarily 
understood.  It  occupies  the  greatest  possible  field  o'f  psychic 
endeavor;  and  while  it  is  useful  and  successful  in  a  large  number 
of  cases,  and  results  in  greatly  strengthening  the  mind,  in  the 
end  it  is  found  to  be  nothing  more  or  less  than  a  process  of 
reeducating  the  will.  It  must  be  remembered  that  it  is  probably 
inadequate  in  marked  cases  of  hysteria,  in  disorders  of  per- 
sonality, and  in  extreme  cases  of  obsession. 

FREE   WILL   AND   DETERMINISM 

It  is  in  the  treatment  of  disorders  of  the  will  of  various  kinds 
that  the  physician  is  brought  to  realize  how  much  harm  is  done 
by  the  teaching  that  determinism  and  not  free  will  rules  life. 


THE  EX  ALT  ATI  OX  OF  THE  WILL  339 

It  is  true  that  we  often  find  cases  in  which  men  and  women 
cannot  use  their  wills  or  at  least  seem  not  to  be  able  to  use  them. 
They  are  lacking  in  some  essential  quality  of  human  mentality. 
We  find  many  human  beings,  however,  doing  things  that  are 
harmful  for  them  and  that  are  so  inveterated  by  habit  that  it  is 
extremely  difficult  to  get  away  from  them.  In  every  case  the 
sane  person  can  conquer  and  break  the  habit,  no  matter  how 
much  of  a  hold  it  may  have  obtained. 

We  have  heard  much  of  the  born  criminal  and  of  the  degenerate 
and  his  inevitable  tendencies,  but  most  of  the  theories  founded  on 
this  phase  of  criminal  anthropology  have  gradually  been  given  up 
as  a  consequence  of  more  careful,  and  above  all.  more  detailed 
observation.  Many  criminals  bear  the  stigmata  of  so-called  degene- 
ration. Many  of  them  have  irregular  heads,  uneven  ears,  some 
fastened  directly  to  the  cheek  and  some  with  the  animal  peak,  many 
have  misshapen  mouths  and  noses,  but,  on  the  other  hand,  many 
people  having  these  physical  qualities  are  good  men  and  women, 
perfectly  capable  of  self-control,  honest,  efficient  members  of  society, 
and  it  is  evident  that  the  original  observations  were  founded  too 
exclusively  on  the  criminal  classes,  instead  of  on  the  whole  popula- 
tion. It  is  important,  then,  to  get  away  from  the  notion  of  irre- 
sponsibility in  these  cases. 

While  men  are  free,  yet  each  in  a  different  way,  and  the  freedom 
of  their  wills  is  as  individual  as  their  countenances,  it  must  not  be 
forgotten  that  the  freedom  of  the  will  is  a  function  of  the  human 
being,  and.  like  all  other  functions,  can  be  increased  or  decreased  by 
exercise  or  the  lack  of  it.  The  old  idea  of  ''breaking  the  will '"  was 
as  much  of  a  mistake  as  that  other  old-fashioned  notion  contempo- 
rary with  it  of  "  hardening  "  children  by  exposing  them  to  inclement 
weather  and  severe  physical  trials.  The  will  may  be  strengthened, 
however,  by  the  exercise  of  it.  and  if  not  exercised  may  it  not  be 
expected,  by  analogy,  at  least,  to  be  as  weak  and  flabby  as  muscles 
would  be  under  similar  circumstances?  The  training  of  the  will  by 
self-denial  and  self-control  is  extremely  important.  When  there  is 
an  hereditary  influence,  a  family  trait,  and  not  merely  an  acquired 
character,  by  which  the  will  rather  easily  passes  out  of  control,  there 
is  all  the  more  need  for  the  training  of  it  in  early  youth.  Without 
such  training  men  may  find  it  impossible  to  make  up  their  minds  to 
deny  themselves  indulgence  of  many  kinds,  but  this  is  not  because 
thev  have  not  free  will,  but  because  this  function  has  never  been 


34o  WORRY  AND  NERVOUSNESS 

exercised  sufficiently  to  enable  them  to  use  it  properly.  A  man  who 
attempts  to  do  gymnastic  feats  without  training  becomes  a  cropper. 
A  man  who  is  placed  in  circumstances  requiring  hard  muscle  exer- 
tion will  fail  if  his  muscles  have  not  been  trained  to  bear  it.  The 
same  thing  will  happen  with  the  will. 

Unfortunately  this  training  of  the  will  has  been  neglected 
to  a  considerable  extent  in  modern  education,  and,  above  all, 
in  modern  families,  where  the  presence  of  but  one  or  two  chil- 
dren   concentrates    attention    on    them,    overstimulating    them 
when  young,  leading  to  self-centeredness  and,  above  all,  dis- 
couraging self-denial  in  any  way  and  preventing  that  develop- 
ment of  thorough  self-control  which  comes  in  the  well-regulated 
large  family.    Besides,  unfortunately,  it  is  just  the  neurotic  indi- 
viduals who  most  need  thorough  training  in   self-control   and 
whose  parents  suffer   from   the   same  nervous   condition    (for, 
while  disease  is  not  inherited,  defects  are  inherited),  that  are 
deprived  of  such  regular  training  in  self-control  because  of  the 
inability  of  their  parents  to  regulate  either  themselves  or  others 
properly.     Here  is  the  secret  of  the  more  frequent  development 
of  neurotic  symptoms  in  recent  years.     It  is  not  so  much  the 
strenuous  life  as  the  lack  of  training  of  the  will  so  that  the 
faculty  of  free  will  can  be  used  properly.    Lacking  this,  hysteri- 
cal symptoms,  unethical  tendencies,  lack  of  self-control  become 
easily  manifest.     The  training  that  would  prevent  these  should 
come  early  in.  life,  and  when  it  does  not  it  is  very  difficult  to 
make  up  for  it  later.    Just  as  far  as  possible,  however,  it  is  the 
duty  of  the  psychotherapeutist  to  supply  by  suggestions  as  to 
training  and  discipline  for  the  education  of  the  will  those  things 
that  have  unfortunately  been  missed. 

SUMMARY   OF   THE   CHAPTER 

i.  Reeducation  of  the  will  is  a  method  of  psychotherapy  dis- 
tinct from  and  in  addition  to  the  practice  of  suggestion,  and  is 
dependent  upon  intelligent,  methodical  and  persistent  educational 
efforts  directed  to  the  exaltation  of  will  power. 

2.  In  average  individuals  there  exists  a  tremendous  dispro- 
portion between  the  high  degree  of  their  intellectual  culture  and 
the  humiliating  weakness  of  their  will  power. 

3.  Will  power  is  the  final  arbiter  of  choice.    It  is  the  supreme 


THE  EXALTATIOX  OF  THE  WILL  341 

court    of    the    intellect,    and    the    battleground    of    character 
formation. 

4.  The  will  represents  to  the  mind  what  the  sum-total  does  to 
a  column  of  figures.  It  is  the  master-builder  of  character  and  the 
architect  of  destiny. 

5.  Man  is  a  responsible  being  —  possessing  the  power  of 
choice.    We  lease  our  minds  for  hire  but  we  never  rent  our  wills. 

6.  The  mind  of  weak  will  thinks  rapidly  and  superficially. 
The  strong  will  compels  deep,  deliberate,  and  logical  thought.  _ 

7.  Without  will-supervision,  the  mind  wanders  aimlessly  in 
the  midst  of  the  pleasant  scenes  of  its  own  imagination. 

8.  Character  formation  represents  the  grand  and  sublime  pur- 
pose of  life  and  is  influenced  by  our  every  thought,  word,  and 
action. 

9.  Conscience  distinguishes  man  from  the  animal,  and  has  for 
its  basis  our  hereditary  and  acquired  mental  attitudes  and  moral 
standards. 

10.  Man  is  a  religious  animal  —  a  spiritual  being.  Primitive 
man  is  always  religious.     He  universally  worships  something. 

11.  Many  nervous  troubles  arise  from  failure  to  regulate  the 
emotions;  'likewise  failure  to  distinguish  between  ideas  and 
emotions. 

12.  Some  nervous  patients  are  the  victims  of  a  continuous 
emotional  riot,  which  results  in  an  endless  array  of  mental  con- 
fusion and  physical  agitation. 

13.  You  can  never  hope  to  succeed  in  the  mastery  of  the  mind 
until  these  desperadoes  of  emotion  are  conquered  and  eliminated. 

14.  Concentration  of  thought  is  natural  to  the  healthy  and 
normal  mind  when  attention  is  secured  and  interest  aroused. 

15.  The  exaltation  of  the  will  by  reeducational  therapeutics 
represents  the  acme  of  modern  psychotherapy. 

16.  The  kaleidoscope  of  thought  steadily  revolves,  sometimes 
quite  independent  of  our  immediate  efforts  to  control  the  proc- 
ess, but  training  will  bring  about  a  high  degree  of  mastery. 

17.  Reeducation  is  practiced  by  fully  and  frankly  explaining 
to  the  patient  his  condition,  just  as  it  appears  to  the  practitioner. 
The  doctor  is  the  teacher,  the  patient  the  pupil. 

iS.  Reeducational  therapeutics  possesses  a  wide  range  both  as 
to  the  physicians  who  may  practice  it  and  the  patients  who  may 
be  benefited  thereby. 

19.  In  the  last  analysis,  man.  by  the  exercise  of  his  power  of 
choice,  is  found  to  possess  a  free  will  and  is  not  a  helpless  victim 
of  biologic  determinism. 

20.  The  calamitv  of  the  present  age  is  the  neglect  of  will- 
training.  The  crv'ing  need  of  the  hour  is  for  an  adjustment  of 
our  educational  system  with  a  view  to  strengthening  the  will. 


CHAPTER   XXVII 
DECISION  DEVELOPMENT 

IN  NUMEROUS  places  throughout  this  work  attention  has 
been  called  to  that  chronic  form  of  indecision  which  is  char- 
acteristic of  the  neurasthenic  states;  while  we  have  repeatedly 
laid  emphasis  upon  those  modes  of  employment  and  those  forms 
of  recreation  which  tend  to  stimulate  the  practice  of  decision. 
In  this  chapter  we  desire  to  lay  the  axe  at  the  root  of  this  tree 
of  indecision  and  inaction. 

THE   WILL    IN    ACTION 

Indecision  represents  a  dormant  will  —  a  sleeping  will  power. 
Will  power  is  comparable  to  the  latent  energy  of  a  chunk  of 
dynamite  or  to  the  potential  possibilities  of  a  great  sixteen-inch 
gun  quietly  resting  on  its  carriage  at  some  seaport  fortification. 
Choice  or  definite  desire  represent  the  explosive  possibilities  of 
the  dynamite  and  the  destructive  powers  of  the  grim  gun,  while 
decision  is  the  explosion  of  the  one  and  the  firing  of  the  other. 

You  may  possess  a  strong  will  and  have  the  very  best  of  inten- 
tions, but  nothing  really  happens  in  the  conquest  of  nerves  until 
you  actually  pull  the  trigger  —  until  you  really  reach  a  final 
decision. 

Decision  represents  the  highest  possibility  of  human  mind 
action ;  it  is  the  most  powerful  influence  which  any  human  being 
can  bring  to  bear  upon  a  confused  brain  and  a  disordered 
nervous  system.  It  is  the  one  power  which  can  modify  and 
control  one's  thoughts,  feelings,  habits,  and  general  behavior. 

The  confused  brain  of  the  confirmed  neurasthenic  and  the  dis- 
ordered nerves  of  the  chronic  psychasthenic  are  little  afraid  of 
or  influenced  by  "  good  intentions,"  "  heart-felt  desires,"  rt  noble 
aspirations,"  or  "high  hopes."  All  of  these  things  put  together 
will  produce  little  or  no  effect  on  a  bad  case  of  "  nerves  " ;  but 

342 


DECISION  DEVELOPMENT  343 

the  very  instant  you  really  decide  that  some  things  must  stop  and 
that  certain  other  things  are  going  to  happen  — that  very  mo- 
ment your  whole  mind  takes  on  a  new  phase  and  your  entire 
nervous  system  begins  to  sit  right  up  and  take  notice. 

DECISION  AND  DESTINY 

Before  you  arrive  at  a  definite  decision,  your  will  power  is 
comparatively  helpless  —  it  is  quite  powerless  to  enforce  the 
mandates  of  your  own  reason  and  judgment;  whereas,  after 
formulating  a  decision  you  find  that  every  soul  power  quickly 
swings  into  line  —  every  force  of  mind  and  every  energy  of 
body  are  immediately  rendered  subservient  to  the  decrees  and 
mandates  of  the  will. 

Now,  at  last  —  and  through  the  power  of  definite  decision  — 
the  human  will  becomes  what  God  designed  it  should  be,  the  all 
powerful  sovereign  guide  and  ruler  of  the  whole  mental,  moral, 
and  physical  domain  of  man's  experience.  But  the  will  does  not 
become  such  a  power  in  one's  life  until  he  has  learned  how  to 
decide  things  —  until  he  has  learned  how  to  reach  definite  con- 
clusions and  then  to  throw  himself  whole  heartedly  and  unre- 
servedly into  the  actual  execution  and  carrying  out  of  those 
conclusions.  That  is  decision,  and  it  never  fails  to  spell  deliver- 
ance for  all  those  nervous  sufferers  who  through  patient  perse- 
verance attain  this  practice. 

The  fearful  and  diffident  business  man  makes  little  headway 
in  this  day  and  generation.  It  is  still  true  that  "  faint  heart 
ne'er  won  fair  lady."  These  victims  of  indecision  still  doubt 
their  religious  experience  and  worry  over  the  forgiveness  of 
their  sins  simply  because  they  cannot  bring  themselves  to  the 
point  of  deciding  —  believing  —  the  very  cardinal  teachings  of 
the  religion  they  professedly  accept. 

The  wars  and  racial  struggles  of  the  past  compelled  decision 
and  action :  and.  in  a  measure,  the  fierce  competitive  struggles 
of  our  present  day  commerce  accomplish  the  same  desirable 
ends,  as  also  do  the  various  competitive  games  and  sports;  but 
none  of  these  things  begin  to  compare  with  the  value  and  force 
of  that  deliberate,  personal,  and  powerful  decision  of  the  mind 
which  one  makes  after  carefully  scrutinizing  the  whole  of  the 


344  WORRY  AXD  NERVOUSNESS 

evidence  submitted  to  the  supreme  court  of  the  human  intellect. 
Such  a  decision  when  once  made,  and  when  the  maker  is  imbued 
with  sufficient  loyalty  and  patriotism,  represents  the  acme  of 
power  and  possibility  in  the  remodeling  and  remaking  of  human 
character. 

Of  course,  the  proper  time  and  place  to  begin  all  this  training 
and  practice  in  deciding  things  —  and  deciding  them  rightly  — 
is  in  childhood.  Teach  the  little  ones  how  to  "  make  up  their 
minds,"  how  to  arrive  at  speedy  and  intelligent  conclusions. 
Help  them  early  to  overcome  hesitation  and  halting 
them  to  reach  settled  positions  on  every  question  which  may 
chance  to  come  up  for  discussion. 

So  important,  indeed,  is  this  matter  of  cultivating  and 
strengthening  one's  decisions  of  the  will,  that  I  think  we  may 
safely  say  that  the  strength  of  one's  character  is  directly  deter- 
mined by  and  is  commensurate  with  the  number  and  magnitude 
of  one's  decisions.  It  is  literally  true  that  the  number  and  viril- 
ity of  one's  d^  is  the  equivalent  of  one's  character. 

STIFLING    THE    WILL 

Indecision  represents  the  fetter-irons  which  manacle  and 
effectively  hold  down  the  strongest  of  human  wills.  Xo  weak 
and  trembling  neurasthene  was  ever  able  to  exalt  his  own  will 
and  deliver  his  soul  from  the  inertia  and  ennui  of  the  nervous 
states  until  he  had  first  conquered  indecision  and  overthrown 
procrastination.  "  Putting  things  oft  "  is  the  bane  of  nervous 
sufferers. 

The  power  of  choice,  the  will,  reason,  judgment,  and  other 
mental  powers  all  represent  a  marvelous  mechanism  wondr 
adapted  for  the  performance  of  certain  highly  specialized  func- 
-  in  the  arena  of  human  affairs :  the  stage  is  perfectly  set. 
the  machinery  is  all  beautifully  fashioned  and  exquisitely  assem- 
bled, but  not  a  wheel  moves,  the  whole  mechanism  is  dead  and 
dormant,  this  vast  organization  of  mind  and  matter  is  powerless 
and  impotent  —  effectually  paralyzed  by  indecision.  Xow  observe 
-ame  inefficient  and  indolent  individual  after  he  begins  to 
wake  up  —  after  he  begins  to  "  make  up  his  mind  "  —  watch  him 
arrive  at  a  final  conclusion ;  let  him  reach  a  decision,  and  then 


DECISION  DEVELOPMENT  345 

like  a  flash  —  like  the  pressing  of  an  electric  button  —  the  whole 
picture  is  instantly  changed;  every  faculty  of  mind  and  body 
suddenly  takes  on  new  life  and  power,  the  dead  and  helpless 
sentiments  and  resolutions  of  yesterday  spring  into  life  and 
become  the  active  and  living  results  of  today.  And  so  while 
indecision  means  weakness  and  death,  decision  actually  breathes 
the  breath  of  life  into  our  slumbering  mentality  and  infuses  new 
life  and  courage  into  our  weak  and  wavering  souls.  Positive 
decision  is  the  resurrection  of  life  to  those  who  sleep  in 
the  neurasthenic  valley  of  the  dry  bones  of  irresolution  and 
indecision. 

PRACTICING  DECISION 

At  just  about  this  point  the  patient  begins  to  ask  questions, 
and  the  first  one  is :  "  But,  doctor,  how  can  I  begin  to  cultivate 
the  decision  habit?  How  shall  I  begin  to  develop  decisiveness?  " 
And  my  reply  is :  "  Just  as  you  would  develop  your  memory  or 
your  muscle  —  by  persistent  exercise." 

Practice  deciding  things  —  practice  making  up  your  mind 
quickly  and  positively;  and  then  when  you  have  made  a  choice, 
be  patriotically  loyal  to  your  decision,  stand  by  your  selection 
and  fight  to  the  last  ditch  for  the  defense  of  the  thing  you 
have  decided  on.  Be  determined  —  only  don't  be  foolish  enough 
to  carry  things  to  that  extreme  where  you  wear  yourself  out 
trying  to  "  carry  through  "  every  trifling  notion  which  might 
chance  to  pass  through  your  mind ;  don't  let  determination  de- 
generate into  common  contrariness.  Choose  good  things  — 
things  and  ideas  worth  while  —  and  then,  like  a  good  soldier, 
stick  to  your  choice  and  stand  by  your  decision. 

In  your  business  affairs  don't  allow  indecision  to  steal  into  the 
handling  of  your  minor  daily  affairs.  Don't  sit  at  the  desk  and 
handle  and  rehandle  your  letters  and  papers.  Take  up  one  thing 
and  put  it  through  —  finish  it.  Don't  form  that  habit  of  travel- 
ing in  a  circle. 

In  the  affairs  of  the  home  don't  flit  from  one  thing  to  another 
and  from  one  room  to  another.  Take  up  one  task  and  stick 
to  it  until  it  is  finished.  Complete  one  job  before  you  begin  an- 
other.   Form  the  habit  of  finishing  things  before  you  leave  them. 


346  WORRY  AND  NERVOUSNESS 

All  of  our  outdoor  sports  and  most  of  our  competitive  games 
afford  opportunities  for  developing  our  reason  and  judgment  and 
in  the  end  to  form  conclusions  —  to  decide  things  —  and  in  this 
way  they  are  all  valuable  adjuncts  in  the  treatment  and  cure  of 
indecision;  and  indecision,  be  it  remembered,  is  typical  of  the 
neurasthenic  state  of  mind. 

But  the  average  patient  needs  to  be  set  at  something  definite 
which  will  help  him  to  perfect  and  develop  his  powers  of  deci- 
sion. We  all  like  those  intense  situations  in  life  which  compel 
decision.  It  is  the  crisis  on  land  or  on  sea  which  calls  forth 
that  superb  decision  which  characterizes  the  conduct  of  the  hero 
as  he  unconsciously  enacts  his  role  of  heroism.  This  is  probably 
the  secret  of  the  almost  universal  appeal  which  gambling  and 
games  of  chance  make  to  the  human  race.  There  seems  to  be 
a  universal  recognition  of  the  need  of  practicing  decision,  and 
yet  so  many  shirk  the  responsibility  unless  it  is  thrust  upon 
them  by  chance  or  accident.  We  seldom  show  what  is  really 
in  us  until  we  encounter  a  crisis. 

When  not  carried  to  extremes,  I  have  found  chess  and  check- 
ers to  be  of  considerable  value  in  this  work  of  occupying  the 
mind  and  at  the  same  time  presenting  frequently  recurring  situa- 
tions which  call  not  only  for  choosing,  willing,  etc.,  but  which 
also  call  for  actual  and  definite  decision.  The  checker  player 
should  think  out  his  situation  carefully,  canvass  the  whole  lay- 
out, and  then  make  his  move  with  determination  and  decision; 
and  then  cheerfully  stand  by  it  —  make  the  best  of  it.  In  pre- 
scribing checkers  as  a  psychotherapeutic  procedure  I  stipulate 
that  a  watch  shall  be  kept  on  the  table  —  and  that  under  no 
circumstances  shall  more  than  sixty  seconds  be  consumed  in 
contemplating  a  move.  In  all  ordinary  cases,  the  move  should 
be  made  within  thirty  seconds.  This  time  element  is  the  one 
thing  essential  in  the  therapeutics  of  checker  playing. 

It  makes  little  difference  whether  you  make  a  good  move  or  a 
bad  move;  the  thing  of  value  is  the  fact  that  you  were  able  to 
reach,  within  sixty  seconds,  a  decision  to  move,  and  executed 
the  decision  —  that  is  the  real  therapeutic  element  in  the  game. 
Entirely  independent  of  who  may  be  the  best  checker  player, 
from  our  standpoint,  he  who  formulates  the  most  decisions  and 


DECISIOX  DEVELOPMENT  347 

most   ably   executes  them  —  executes   them   most   courageously 
and  fearlessly  —  is  getting  the  greatest  good  out  of  the  game. 

SETTLING  THINGS 

There  are  a  lot  of  good  people  in  this  world  who  are  ever- 
lastingly "  on  the  fence  "  —  they  never  seem  to  be  able  to  get 
anything  settled.  Now,  when  these  unfortunate  people  get 
neurasthenia  —  and  they  are  just  the  ones  who  most  frequently 
do  —  they  are  very  apt  to  have  a  bad  case  of  it.  These  chroni- 
cally undecided  patients  have  simply  got  to  learn  how  to  "  set- 
tle things"  —  and  then  to  settle  it  that  they  are  settled. 

I  think  I  can  probably  help  my  indecision  readers  by  relating 
how  one  of  my  nervously  hoodooed  patients  cured  himself  of 
this  everlasting  halting  between  two  opinions.  He  was  very 
fond  of  taking  long  walks  in  the  city.  He  was  in  the  habit 
of  walking  from  fifty  to  one  hundred  blocks  every  day.  This 
patient  complained  to  me  of  the  monotony  of  having  always  to 
walk  on  one  certain  street;  whereupon  I  asked  him  why  he  did 
not  vary  his  route,  and  this  was  his  reply :  "  Well,  you  see, 
doctor,  it  is  like  this.  When  I  am  out  walking  I  am  constantly 
worrying  about  whether  I  shall  turn  to  the  right  or  turn  to  the 
left:  and  so  in  order  to  avoid  the  pain  and  torture  of  deciding, 
I  keep  straight  ahead."  I  found  that  it  was  a  real  misery  for 
this  man  quickly  to  decide  whether  he  should  turn  to  the  left 
or  to  the  right  when  he  was  out  taking  his  "  constitutional  " 
stroll.  Within  six  weeks  he  soundly  cured  himself  of  this  pecu- 
liar indecision  by  carrying  out  my  instructions,  which  were  as 
follows :  Xever  to  walk  over  three  blocks  without  turning  a 
corner.  Pay  no  attention  to  which  way  you  are  to  turn  until  you 
get  right  up  to  the  corner.  Carry  a  nickel  or  a  dime  in  the  palm 
of  the  hand  and  just  as  you  reach  the  corner  flip  the  coin, 
(heads,  turn  to  the  right;  tails,  turn  to  the  left).  Call  the  direc- 
tion out  loud,  and  wheel  instantly  in  the  direction  which  the 
flipping  of  the  coin  had  determined.  The  cure  in  this  case 
was  complete  and  perfect.  This  patient  later  reported  to  me 
that  he  had  become  "  fascinated  with  the  game  "  —  that  he  had 
kept  a  tally  on  himself  for  the  last  one  thousand  blocks  and  that 
he  had  turned  542  times  to  the  left  and  458  times  to  the  right. 


348  WORRY  AXD  XERVOUSXESS 

Having  gained  the  victory  over  indecision  on  this  minor  point, 
this  patient  carried  the  fight  on  through  his  experience,  and  it 
proved  to  be  a  mighty  factor  in  his  emancipation  from  the 
slavery  of  "  nerves." 

DISCIPLINE    AS    A    REMEDY 

It  was  the  experience  of  this  patient  that  led  me  seriously  to 
consider  the  advisability  of  utilizing  gymnasium  drills,  physical 
culture  classes,  and  military  drills  as  helpful  aids  in  cultivating 
decision  —  instantaneous  obedience  to  the  orders  issued  —  im- 
mediate action  on  the  command  given.  I  found  this  class- 
discipline  invaluable  in  combating  this  sort  of  chronic  neuras- 
thenic indecision,  and  have  systematically  used  these  methods 
from  that  day  to  the  present  time. 

Even  the  necessary  discipline  and  decision  required  to  run 
an  automobile  is  of  value  in  training  the  patient  in  habits  of 
decision.  When  hesitating  over  trifles,  form  the  habit  of  allow- 
ing yourself  not  more  than  three  chances  to  decide;  on  the  third 
attempt  call  "  strikes  "  on  yourself  —  "  three  strikes  and  out  "  — 
and  force  yourself  to  stand  by  the  third  choice.  Establish  this  as 
one  of  the  laws  of  your  program  —  and  then  stick  to  the  "  rules 
of  the  game." 

After  practicing  immediate  obedience  to  the  commands  of  a 
drill  master  or  gymnasium  leader  for  a  few  weeks,  you  so  accus- 
tom yourself  to  instantaneous  decision  that  it  becomes  much 
easier  to  secure  prompt  action  on  the  part  of  both  mind  and 
body  in  response  to  your  own  mental  mandates. 

It  is  in  this  very  manner  that  loyalty  to  your  doctor  and 
implicit  obedience  to  his  orders  help  you  to  stem  the  tide  of 
indecision  and  aid  you  in  getting  the  mind  trained  and  disci- 
plined to  the  point  where  it  will  both  obey  orders  and  decide 
policies  —  formulate  decisions  —  and  all  this  is  highly  essential 
to  the  cure  of  nervousness. 

FORCED  DECISIONS 

In  every  possible  situation  in  life  watch  for  opportunities  to 
force  the  mind  to  definite  decision  —  and  give  little  worry  to  the 
fact  that  vou  so  often  decide  in  the  wrong.    That  is  of  little  con- 


DECISIOX  DEVELOPMENT  349 

sequence;  that  is  a  matter  of  judgment  and  experience.  The  all 
important  thing  is  the  development  of  the  power  of  decision  — 
and  that  is  accomplished  just  the  same  and  just  as  well  in  the 
case  where  you  make  a  mistake  as  in  the  case  when  you  were 
right.  It  is  the  exercise  and  practice  that  make  perfect.  You 
can't  steer  a  ship  when  it  is  standing  still  but  start  the  propellers 
— -even  if  it  is  headed  in  the  wrong  direction  —  and  a  wise 
pilot  can  quickly  wheel  it  around  and  point  her  nose  towards 
the  port  of  desire. 

Therefore,  in  your  battle  with  "  nerves,"  the  most  powerful 
weapon  you  can  ever  wield  is  the  simple  experience  of  "  making 
up  your  mind  ??  to  get  well,  "  making  up  your  mind  "  to  triumph 
over  every  obstacle  and  overcome  every  handicap.  Learn  how 
to  reach  final  decisions  and  then  "  stand  pat  "  until  you  can 
begin  to  realize  that  the  victory  is  yours  and  the  battle  won. 

SUMMARY    OF   THE    CHAPTER 

1.  Definite  decision  represents  the  will  in  action.  Will  power 
is  latent  energy  —  decision  is  applied  energy. 

2.  Xothing  really  happens  in  the  conquest  of  nerves  until  you 
pull  the  trigger  of  decision. 

3.  Decision  represents  the  highest  possibility  of  human  mind 
action ;  it  is  a  power  which  can  modify  and  control  one's  thoughts, 
feelings,  and  habits. 

4.  Decision  swings  every  soul  power,  every  force  of  mind  and 
every  energy  of  body  into  line  and  renders  them  all  subservient 
to  the  mandates  of  the  will. 

5.  Decision  never  fails  to  spell  deliverance  for  all  neurotics 
who  by  patient  perseverance  attain  its  practice. 

6.  Indecision  means  defeat  in  business,  society,  politics,  and 
religion. 

7.  Competitive  commerce,  competitive  sports,  and  common 
•games  all  contribute  situations  which  aid  in  the  development  of 
decision. 

8.  Deliberate  and  calm  decision  represents  the  acme  of  power 
and  possibility  in  the  remodeling  of  human  character. 

9.  Early  childhood  is  the  proper  time  to  begin  decision  prac- 
tice.    Tea'ch  the  children  how  to  "  make  up  their  minds."' 

10.  The  strength  of  one's  character  is  directly  determined  by 
and  is  commensurate  with  the  number  and  magnitude  of  one's 
decisions. 

11.  Indecision  represents  the  fetter-irons  which  manacle  and 
effectively  hold  down  the  strongest  of  human  wills. 


350  WORRY  AND  NERVOUSNESS 

12.  "Putting  things  off"  is  the  bane  of  neurasthenics;  and 
the  conquest  of  indecision  is  the  secret  of  overthrowing  pro- 
crastination. 

13.  The  marvelous  mechanism  of  mind  and  body  are  all  effect- 
ually paralyzed  by  indecision.  Decision  infuses  new  life  into  the 
entire  organization. 

14.  Decision  is  developed  by  persistent  exercise  —  just  as  you 
strengthen  and  develop  your  memory  or  your  muscles. 

15.  Be  determined;  but  don't  make  the  mistake  of  trying  to 
"  carry  through  "  every  trifling  notion  which  may  enter  your 
head. 

16.  Look  out  for  indecision  in  your  daily  business  affairs  or 
household  duties.    Finish  one  thing  before  you  begin  another. 

17.  Remember  how  the  man  cured  himself  of  direction-inde- 
cision by  flipping  the  coin  at  the  corner. 

18.  Chess  and  checkers  when  played  on  a  time  limit  for 
"  moves  "  are  highly  valuable  in  many  cases.  They  present  fre- 
quently recurring  situations  which  involve  decision. 

19.  Remember  —  the  wrong  move  you  make  develops  decision 
just  as  well  as  the  right  one.  Decision  is  the  thing  you  are 
after;  practice  will  perfect  judgment. 

20.  Get  over  the  habit  of  being  "  on  the  fence."  Learn  how  to 
"  settle  things  "  —  and  settle  it  that  they  are  settled. 

21.  Gymnasium  drills,  physical  culture  classes,  and  military 
drills  are  all  helpful  in  developing  decision  and  instantaneous 
obedience. 

22.  Even  the  discipline  and  decision  required  to  run  an  auto- 
mobile are  an  aid  in  combating  chronic  indecision. 

2^.  Loyalty  to  your  doctor  and  implicit  obedience  to  his  orders 
help  you  to  stem  the  tide  of  indecision. 

24.  Watch  for  opportunities  to  force  the  mind  to  make  definite 
decisions. 

25.  Make  up  your  mind  to  get  well  —  make  up  your  mind  to 
triumph  over  every  obstacle  —  and  then  "  stand  pat  "  until  you 
can  recognize  that  the  victory  is  yours. 


CHAPTER  XXVIII 
THE  RELIEF  OF  REPRESSED  EMOTIONS 

THIS  new  theory  of  modern  psychotherapy  assumes  that  all 
functional  nervous  disorders  such  as  afflict  neurasthenics, 
psychasthenics,  and  hysterics,  largely  have  their  origin  in  some 
emotional  stress  or  repression.  It  is  taught  that  these  emotions 
quite  often  arise  in  early  childhood,  when  they  are  little  under- 
stood or  when,  through  fear  or  conventionality,  their  expression 
is  found  to  be  impossible  or  undesirable.  This  original  experi- 
ence of  emotional  submergence  may  be  entirely  forgotten  in 
later  years,  but  is  believed  to  be  able  to  give  rise  to  a  train  of 
subsequent  morbid  feelings  and  impulses  which  are  able  later  to 
torture  the  mind  and  disorder  the  lives  of  these  nervously  pre- 
disposed individuals. 

THE  METHOD  OF  PSYCHANALYSIS 

The  methods  of  psychanalysis  aim  at  going  back  in  an  analyti- 
cal manner  into  the  patient's  mind  to  rediscover  and  recall  to  the 
consciousness  these  mischief-making  emotional  mummies,  and 
then  to  lead  the  patient  to  a  free  and  full  confession  of  these 
hidden  feelings  and  emotions  and  thus  to  relieve  the  mind  of 
its  secret  burdens.  In  this  way  the  nervous  individual  is  able 
to  obtain  that  relief  and  satisfaction  which  invariably  accom- 
panies the  free  and  unhampered  expression  of  one's  thoughts 
and  feelings,  and  there  can  be  no  questioning  of  the  fact  that 
this  work  of  discovering  buried  emotions  and  assisting  the 
patient  in  his  confession  and  elimination  is  immediately  fol- 
lowed by  a  tremendous  increase  in  the  patient's  peace  of  mind 
as  well  as  by  an  enormous  improvement  in  his  nervous  symp- 
toms and  physical  behavior. 

While  Freud  utilized  this  idea  of  mental  catharsis  in  his  new 
system  of  psychotherapeutics,  nevertheless,  we  believe  it  was 
Breuer  who  was  in   reality  the  originator  of  this  method  of 

351 


352  WORRY  AXD  NERVOUSNESS 

psychotherapy,  although  he  did  not  attach  the  sex  significance 
to  his  teachings  that  Freud  does.  Whatever  the  criticism  that 
we  may  make  of  the  school  of  psychanalysis,  we  must  commend 
it  for  its  utter  disregard  of  hypnotism  and  associated  methods 
which  characterized  the  early  French  practitioners  of  psycho- 
therapy. 

MEMORY   EXPLORATION 

The  patient  in  his  efforts  to  search  back  into  early  childhood 
for  lost  memories  and  repressed  emotions  is  aided  by  an  appeal 
to  his  association  centers  through  the  speaking  or  writing  of 
suggestive  words,  while  he  (the  patient)  is  requested  to  men- 
tion other  words  that  are  directly  related  in  his  mind  to  those 
suggested;  for  instance,  the  word  "barn"  suggests  the  word 
"  horse."  The  word  "  horse  "  suggests  a  "  drive  in  the  country," 
and  this  in  turn  suggests  a  runaway  long  ago,  the  buried  fear  of 
which,  with  its  accompanying  emotional  fright,  has  uncon- 
sciously made  the  patient  nervous  during  every  carriage  ride 
from  that  day  to  this. 

I  am  able  to  share  some  of  the  enthusiasm  of  these  teachers 
of  the  psycho-analytic  method,  for  the  brilliancy  and  perma- 
nency of  the  results  attendant  upon  the  actual  discovery  and 
literal  elimination  of  these  mental  burdens  of  repressed  emo- 
tion are  highly  gratifying,  but  I  am  forced  to  take  issue  with 
Freud  and  his  colleagues,  who,  I  think,  enormously  overestimate 
the  influence  and  significance  of  submerged  sex  impulses  and 
repressed  erotic  experiences.  I  am  becoming  more  and  more 
convinced  that  these  practitioners  who  find  disturbances  of  the 
sexual  experience  to  be  at  the  bottom  of  all  cases  of  nervous 
disorder  and  functional  psychic  derangement  have  fallen  into 
the  error  of  mistaking  the  results  of  their  own  unwise  sugges- 
tions to  the  patient  for  fundamental  causes  of  disease.  By  this 
I  mean  that  it  is  entirely  possible  in  the  examining  and  ques- 
tioning of  nervous  patients  so  to  conduct  the  investigation  and 
to  place  such  over-emphasis  upon  the  sex  element  of  the  mental 
contents  as  to  deceive  ourselves  into  the  over-recognition  of  the 
relative  importance  of  these  particular  forms  of  emotion  as  a 
cause  of  functional  nervous  derangements. 


RELIEF  OF  REPRESSED  EMOTIOXS  353 

MENTAL    CATHARSIS 

The  real  aim  of  psychanalysis  is  quite  different  from  the  pur- 
pose and  methods  of  suggestion.  It  is  the  aim  of  suggestion  to 
counteract,  substitute,  and  abolish  unhealthy  ideas,  quite  regard- 
less of  their  nature  and  origin ;  but  the  more  recent  methods 
of  psychotherapy  —  mental  catharsis  —  aim  at  tracing  these  dis- 
ordered ideas  back  to  their  psychological,  physiological,  or  socio- 
logical source,  and  thus  seek  to  eliminate  them  from  the  psychic 
domain,  root  and  branch,  and  so  far  as  the  philosophy  of  this 
method  is  concerned,  it  is  far  from  recent.  Aristotle,  the  Greek 
philosopher,  advocated  some  such  a  procedure  designed  to  purge 
the  mind  of  its  inharmonious  emotions,  and  he  regarded  such 
therapeutic  methods  as  the  acme  of  educational  art.  He 
assigned  to  the  drama  as  its  chief  function  the  elimination  or 
catharsis  of  pity  and  terror.  That  nervous  terror  and  emo- 
tional repression  can  be  relieved  by  elimination  and  expres- 
sion is  demonstrated  by  the  satisfaction  and  relaxation  which  so 
often  follows  the  giving  vent  to  one*s  feelings  during  periods 
of  excitement  or  temper,  although  such  methods  of  getting  relief 
are  far  from  ideal. 

Every  human  being  is  destined  to  carry  throughout  life  more 
or  less  of  an  emotional  reserve;  but  those"  emotions  which  pro- 
duce the  greatest  havoc  in  our  psychic  experience  belong  more 
largely  to  that  class  of  human  feelings  and  impulses  which  are 
so  largely  misunderstood,  or  not  understood  at  all,  by  the 
average  man  or  woman  —  particularly  the  young.  It  is  this 
lack  of  biologic  education,  this  lack  of  self-understanding,  that 
enables  the  common  and  universal  impulses  of  anger,  jealousy, 
fear,  and  the  sexual  emotions,  to  exert  such  a  disastrous 
influence  upon  the  well-being  of  the  mental  and  nervous  health 
of  the  individual. 

YOUTHFUL    CONFIDENCES 

Confidential  talks  on  the  part  of  the  young  with  their  parents 
and  the  conferences  of  the  confessional  or  the  consulting  room 
on  the  part  of  adults  with  their  religious  and  medical  advisors 
all  constitute  a  sort  of  indirect  system  of  psychic  catharsis.  It 
would  seem  that  the  verv  moment  a  human  mind  —  especially 


354  WORRY  AND  NERVOUSNESS 

that  of  the  young,  the  nervous,  and  the  emotional  —  becomes 
locked  within  itself,  that  the  accumulation  of  unexpressed  feel- 
ings, together  with  the  birth  and  growth  of  uneliminated  emo- 
tions, are  soon  able  to  produce  such  a  state  of  nervous  tension 
and  self-consciousness  as  to  jeopardize  the  health  and  happiness 
of  these  self-centered  and  mind-locked  individuals. 

Especially  is  it  advisable  during  adolescence  that  parents  and 
teachers  should  literally  and  liberally  share  the  emotional  life 
of  the  boy  or  girl  who  is  just  blossoming  into  manhood  and 
womanhood.  It  is  at  these  critical  periods  of  life  that  the  freest 
expression  of  the  thoughts  and  feelings  should  be  encouraged 
and  should  be  sympathetically  and  intelligently  entered  into  by 
the  natural  guardians  who  are  entrusted  with  the  responsibility 
of  skillfully  guiding  the  ship  of  being  through  the  troublous 
waters  which  prefigure  this  critical  period  of  every  human's 
life. 

SEX  EMOTIONS 

I  recently  had  under  my  care  a  semi-hysterical  young  woman 
who  had  previously  been  treated  by  these  methods  upon  the 
hypothesis  that  her  hysterical  tendencies  were  all  anchored  in 
some  repression  or  derangement  of  the  sexual  life,  and  after 
making  splendid  progress  for  a  number  of  months  in  response 
to  treatment  along  the  lines  of  educational  therapeutics,  she 
confided  to  me  one  day  that  she  seriously  doubted  having  been 
guilty  of  many  of  the  sexual  experiences  to  which  she  had 
confessed  while  undergoing  her  former  course  of  treatment  and 
added  this  significant  statement:  "  Really,  doctor,  I  think  some 
of  these  things  were  put  into  my  head  by  the  constant  talking 
about  sex  matters  during  the  course  of  my  treatment  and  by 
being  so  emphatically  told  that  all  my  nervous  troubles  had  their 
root  and  origin  in  some  derangement  of  my  psychic  sex  life." 
And  I  was  bound  to  admit  to  the  patient  that  I  concurred  in  her 
conclusion. 

The  average  person  is  more  highly  suggestible  in  matters 
pertaining  to  sex  than  in  any  other  avenue  of  human  experience. 
It  is  not  at  all  difficult,  therefore,  to  explain  or  understand  how 
enthusiasts,  who  are  working  along  these  lines  of  sex  emotion  as 


RELIEF  OF  REPRESSED  EMOTIONS  355 

the  exclusive  field  for  psychanalysis,  are  able,  almost  without 
exception,  to  arrive  at  some  sort  of  sex-error,  which  they  could 
seize  upon  as  the  etiologic  factor  wholly  responsible  for  the 
patient's  neurosis.  I  think  it  is  the  failure  to  recognize  this 
fact  of  sex-suggestion  that  has  led  Freud  and  his  school  so  far 
afield  from  what  is  otherwise  the  most  highly  scientific  and 
rational  school  of  psychotherapeutic  procedure  which  has  been 
developed  up  to  date. 

It  is  my  opinion  that  while  sex  emotions  are  often  the  exclu- 
sive cause  of  our  nervous  troubles  and  are  more  or  less  con- 
cerned in  practically  every  individual  suffering  from  a  psycho- 
neurosis,  nevertheless,  I  have  been  able  to  dig  up  in  the  minds 
of  these  patients  and  bring  forth  other  offending  complexes, 
the  central  idea  of  which  was  fear,  fright,  regret,  sorrow, 
together  with  other  moral  and  spiritual  delinquencies,  apparently 
without  the  pale  of  the  sex  realm. 

SELF-ANALYSIS 

I  think  the  mistake  that  the  practitioners  of  psychanalysis 
have  made  is  that  they  have  done  too  much  of  the  analyzing 
themselves.  In  some  cases  I  find  it  better  to  direct  efforts  along 
this  line  in  the  channels  of  self-analysis,  expertly  guiding  the 
patient  while  she  digs  down  into  her  mind  and  brings  forth 
these  ancent  psychic  slivers  which  are  the  cause  of  her  mental 
unrest  and  nervous  dissatisfaction.  It  must  be  remembered  in 
treating  these  patients  (when  they  have  reached  a  certain  stage) 
that  the  less  we  do  for  them  as  physicians,  the  better  it  is  for 
the  patient  and  the  permanency  of  their  cure.  I  lost  all  faith 
in  this  exclusive  sexual  origin  of  the  psycho-neuroses  when, 
as  a  result  of  a  few  experiments  in  the  clinic.  I  discovered  I 
could,  in  the  case  of  suggestible  and  hysteric  patients,  lead  them 
to  believe  in  and  settle  upon  almost  any  idea  that  I  forcefully 
reiterated  as  a  cause  of  their  nervous  troubles. 

The  most  important  item  in  the  treatment  of  these  cases,  even 
if  the  offending  complex  is  essentially  one  concerned  in  the  sex 
life  of  the  patient,  is  to  so  arrange  the  recreational,  vocational, 
and  domestic  life  of  the  individual  that  the  mind  which  has 
become  so  highly  sensitized  to  these  morbid  sex  feelings  shall 


356  WORRY  AXD  XERJrOUSXESS 

be  crowded  brim  full  of  healthy  interests  and  normal  ideas, 
which  shall  be  so  well  cultivated  that  they  will  literally  sweep 
the  diseased  mind  clean  of  these  disordered,  unhealthy,  and 
unwholesome  feelings  and  impulses.  All  physical  means,  such 
as  baths,  massage,  and  electricity,  as  well  as  outdoor  and  ath- 
letic exercises,  should  be  utilized  as  therapeutic  aids  to  help 
these  minds  in  the  great  fight  to  restore  themselves  to  a  health- 
ful and  normal  attitude. 

PSYCHOTHERAPEUTIC   PROPRIETIES 

Some  practitioners  of  psychanalysis  go  so  far  as  to  practically 
put  a  sexual  interpretation  upon  every  dream  that  passes 
through  the  human  mind,  and  in  the  opinion  of  the  author,  their 
efforts  in  this  direction  are  frequently  absurdly  ridiculous,  as 
well  as  being  far  from  wholesome  and  uplifting  upon  the  mind 
of  the  patient.  The  attachment  of  the  patient  to  the  physician, 
so  prone  to  occur  in  hysteric  subjects  if  the  physician  be  at  all 
lax  in  his  attitude,  is  peculiarly  fostered  by  these  exclusive  sex 
teachings  of  certain  practitioners  of  psychanalysis.  There  are 
the  daily,  or  almost  daily,  long-continued  conversations  on  sex- 
ual matters  extending  over  many  months  of  time  —  sometimes 
as  long  as  three  years  —  conversations  of  the  most  intimate 
character.  I  look  upon  it  as  an  utterly  unethical  and  highly 
unhealthy  experience  for  nervous  patients  —  especially  neurotic 
and  hysterical  young  women  —  to  go  to  the  physician's  office  for 
repeated  and  lengthy  consultations  in  which  the  center  and 
theme  of  conference  is  the  subject  of  the  patient's  sex  life.  I 
think  such  patients,  notwithstanding  their  evident  need  of  psy- 
chotherapeutic aid,  will  get  more  good  in  the  end  if  they  will 
take  to  the  woods,  study  the  birds,  gather  flowers,  or  engage 
in  some  other  form  of  suitable  and  wholesome  social  diversion 
and  recreation.  And  all  this  I  say  with  a  full  recognition  that 
there  is  more  or  less  disorder  of  the  sexual  life  in  the  vast 
majority  of  all  our  neurotic  patients,  both  single  and  married. 
I  do  not  ignore  this  element  in  my  treatment  of  these  cases,  as  I 
find  myself  most  fortunately  situated  in  that  my  good  wife  is 
also  my  professional  associate.  And  all  this  I  mention  merely 
to  make  clear  that  while  I  cannot  follow  the  Freudian  school 


RELIEF  OF  REPRESSED  EMOTIOXS  357 

in  some  of  its  philosophy,  and  while  I  regard  the  over-emphasis 
of  sex  matters  as  highly  disastrous  and  deteriorating  in  the  prac- 
tice of  psychotherapy,  nevertheless,  I  am  equally  wide-awake 
to  recognize  the  necessity  of  properly  treating  and  eliminating 
whatever  of  disordered  impulses  and  emotions  of  this  nature 
may  be  present  in  the  mind  and  experience  of  any  given 
patient. 

The  time  has  come  to  utter  both  protest  and  warning  against 
this  tendency  to  direct  psychotherapy  into  sordid  and  sexual 
channels.  I  am  beginning  to  think  that  the  future  will  look 
back  upon  the  present  day  and  generation  as  having  gone  sex- 
mad.  The  red-light  district  seems  to  be  monopolizing  the  stage 
and  to  possess  the  brains  of  a  majority  of  our  novelists,  and 
now  this  modern  sex  mania  threatens  to  take  possession  of 
psychic  medicine,  and  if  mental  medicine  is  to  be  directed  into 
these  exclusive  and  suggestive  fields,  great  harm  is  going  to 
be  done  to  the  minds  of  our  nervous  patients.  Unwholesome 
and  undesirable  association  of  ideas  are  going  to  be  suggested 
to  the  minds  of  nervous  sufferers  and  they  are  going  to  be 
tormented  with  these  unwholesome  and  undesirable  associations 
throughout  the  rest  of  their  lives.  Immorality  both  in  thought 
and  act  can  only  be  the  outcome  of  these  foolish  and  absurd 
teachings  regarding  the  cause  and  cure  of  our  common  nervous 
disorders. 

EMOTIONAL    REPRESSION 

It  is  indeed  pathetic  to  note  the  large  number  of  square 
human  pegs  who  are  trying  to  fit  into  vocational  round  holes  — 
sociological  misfits,  human  plants  that  are  trying  to  grow  in 
the  wrong  climate.  We  find  cases  among  both  men  and  women, 
but  more  particularly  among  women  who  are  growing  old, 
getting  well  up  into  the  thirties.  They  find  themselves  alone 
in  the  world.  They  not  only  have  no  one  to  love  them  but  they 
are  in  a  worse  state  —  they  have  no  one  to  love,  and  they  get 
into  that  morbid  state  of  mind  where  they  feel  there  is  not  a 
single  soul  in  the  world  who  really  understands  them.  They 
may  naturally  not  be  oversuccessful  in  making  their  way  along 
in  social  circles,  and  then  to  all  this  is  added  the  anxiety  and 


353  WORRY  AND  NERVOUSNESS 

worry  not  only  of  earning  a  livelihood,  but  as  to  what  they  shall 
do  in  the  future  as  they  grow  older.  About  this  time  some 
form  of  nervousness  begins  to  make  its  appearance,  either 
spontaneously  on  the  basis  of  heredity,  coupled  with  this  expe- 
rience of  loneliness  and  isolation,  or  as  a  result  of  some  mental 
overworry,  physical  overwork,  or  perchance,  some  catastrophe 
in  the  individual's  experience  or  that  of  his  family,  and  then 
the  real  mischief  —  nervous  prostration  —  shows  its  hand. 

In  other  cases  the  real  nervousness  begins  as  a  child,  it  may 
be  with  a  violent  whipping  or  some  other  unusually  harsh  crit- 
icism. It  may  come  with  disappointment  in  love  or  the  discov- 
ery of  the  unfaithfulness  of  the  adored  one,  or  it  may  be  sud- 
den death  in  the  family.  In  this  way  the  foundation  is  laid 
for  a  life-long  invalidism  if  the  patient  does  not  by  chance  fall 
into  the  expert  hands  of  a  sympathetic  medical  counselor. 

Sometimes  we  find  the  musician,  the  artist,  or  the  author, 
that  is  those  who  have  had  longings  and  ambitions  in  these 
directions,  but  who  have  failed  —  at  least  they  have  failed  to 
make  a  commercial  success  erf  their  art  —  and  these  individuals, 
especially  in  maiden  ladies  and  old  bachelors,  begin  to  become 
self-centered  and  break  down  their  health  by  brooding  over 
their  failures  and  worrying  about  their  future.  Again  we  find 
those  who  do  not  seem  to  be  able  to  express  their  affection  in 
terms  which  other  members  of  society  can  recognize  or  appre- 
ciate. It  was  one  such  patient  as  this  who,  in  writing  to  her 
physician,  thus  described  her  unsatisfied  longings:  "Is  there 
no  one  in  the  world  who  cares  to  be  deeply  loved?  Perhaps 
it  is  that  only  deep  natures  can  bear  to  receive  deep  devotion, 
and  that  the  ordinary  person,  under  these  circumstances,  merely 
feels  disgust  and  resentment  toward  those  who  bring  to  the 
surface  that  which  hitherto  had  been  submerged  and  unsus- 
pected. I  cannot  understand  it  at  all,  but  I  feel  convinced  that 
there  is  in  me  some  force  which,  denied  a  natural  outlet,  could 
still  be  utilized  and  made  productive  in  some  direction." 

PHYSIOLOGY    OF    THE    EMOTIONS 

When  we  come  to  analyze  and  summarize  the  views  of  Lange, 
James,  and  other  students  of  the  physiology  and  the  mechanics 


RELIEF  OF  REPRESSED  EMOTIOXS  359 

of  emotion,  we  are  further  forced  to  the  conclusion  that  those 
commingled,  complex  feelings  of  sensation  and  consciousness 
which  we  commonly  call  emotions  are  the  result  of  a  whole 
series  of  disturbances  and  reactions  in  the  motor,  vasomotor, 
and  glandular  mechanism  of  the  body;  in  other  words,  what 
we  call  the  emotion  is  simply  our  recognition  —  our  conscious- 
ness —  of  these  physical  changes  which  are  taking  place  in  the 
organism.  Xow,  I  cannot  accept  this  purely  physiological  view 
of  the  origin  of  human  emotions.  I  believe  that  the  mental 
state  also  contributes  to  the  production  of  these  characteristic 
and  peculiarly  human  feelings.  When  James  says  that  we  suf- 
fer from  a  sense  of  affliction  because  we  weep,  that  we  are 
angry  because  we  fight,  and  that  we  are  frightened  because 
we  tremble,  I  can  only  partially  agree  with  him.  I  must  also 
recognize  the  fact  that  when  a  mother  has  lost  an  only  child, 
she  first  experiences  a  perception,  an  idea,  and  that  it  is  this  idea 
that  saddens  her,  and  then  her  sorrow  is  shown  and  accom- 
panied by  tears.  Of  course,  it  may  be  argued  that  the  major- 
ity of  our  mental  representations  —  our  ideas  —  are  also  awak- 
ened by  peripheral  stimuli,  and  it  is  only  in  the  light  of  this 
latter  argument  that  we  can  accept  of  a  teaching  which  as- 
signs the  origin  of  all  emotion  to  purely  physical  conditrons  in 
the  organism. 

One  authority,  in  summing  this  matter  up,  has  expressed  our 
views  so  well  that  we  beg  to  quote  as  follows : 

In  the  last  analysis  man  experiences  emotions.  This  ultimate 
phenomenon  is  psychic  and  irreducible.  Why  should  it  occur  more 
easily  because  we  have  vaguely  noticed  our  heart  beats  and  tears 
in  our  eyes?  Why  should  it  not  follow  directly,  as  one  idea  follows 
another,  the  mental  representation  of  the  death  of  some  one  we 
love  ?  To  pretend  that  we  weep  first,  and  that  we  are  moved  after- 
ward, is,  as  our  authors  naively  acknowledge,  to  wound  common 
sense,  the  guiding  quality  of  intelligence.  The  first  characteristic  of 
emotion  is,  to  my  mind,  its  ideogenic  origin.  Then  follows  the 
irradiation  of  the  stimulus  to  other  centers,  the  wakening  of  previous 
mental  representations  that  are  instinctive  or  acquired,  creating 
psychic  emotion.  Then  follow  the  physiological  manifestations  of 
the  mental  condition  in  the  form  of  actions,  which  are  always  con- 
secutive to  the  idea.     Many  persons   allow  themselves   to  be  im- 


360  WORRY  AND  NERVOUSNESS 

pressed  by  all  the  sensations  that  they  experience.  Some  functional 
disorder  which  would  leave  a  well-balanced  person  wholly  indifferent 
strikes  them  with  fear.  If  they  have  a  palpitation  of  the  heart,  they 
immediately  dread  imminent  syncope;  a  sensation  of  vertigo  makes 
them  fear  for  their  head.  They  are  afraid  of  all  diseases ;  they  are 
often  even  afraid  of  fear.  This  is  so  frequent  that  physicians  have 
invented  the  term  "  Phobophobia." 

MEMORY    GHOSTS 

In  the  treatment  of  neurasthenics  and  hysterics,  at  just  about 
that  time  when  we  feel  the  patient  is  making  splendid  progress, 
achieving  an  excellent  conquest  of  their  disjointed  minds  and 
disordered  memories  —  just  about  this  time,  they  come  into  the 
office  in  utter  despair  and  tell  you  that  since  their  last  confer- 
ence with  you  they  have  suffered  the  tortures  of  the  damned. 
They  begin  a  rehearsal  of  all  their  former  bad  symptoms  and  in 
pathetic  tones  assure  you  that  everything  is  just  as  bad  or 
worse  than  before  they  began  treatment. 

Now,  calm,  cool,  and  careful  analysis  of  what  they  tell  you 
almost  unfailingly  reveals  the  fact  that  they  are  suffering  from 
what  I  call  "  memory  ghosts."  By  this  I  mean  that  the  memory 
images  of  their  former  disastrous  experiences  have  been  able 
to  encompass  the  consciousness  in  such  a  way  as  to  torture  and 
terrorize  these  neurotic  souls.  We  are  usually  able  to  point 
out  to  such  patients  the  definite  improvement  they  have  experi- 
enced in  other  directions,  and  are  usually  able  to  make  suffi- 
ciently clear  to  them  the  nature  of  their  mental  tortures  that 
they  leave  the  office  recognizing  that  while  one  can  change  his 
habit  of  thought  by  persistent  training,  and  do  so  in  a  com- 
paratively short  time,  he  must  reckon  with  the  fact  that  the 
memories  of  former  habits  of  misthought  may  long  linger 
in  the  mind,  that  these  "  memory  ghosts "  may  walk  forth 
during  the  dark  hours  of  depression  and  thus,  at  a  time  when 
one  is  least  able  to  resist  them,  take  that  unfair  advantage  of 
the  patient  which  seldom  fails  to  precipitate  a  veritable  psychic 
panic. 

Xeurasthenics  are  all  the  time  complaining  of  and  suffering 
from  the  sudden  appearance  of  distressing  and  alarming  symp- 
toms for  which  there  seems  to  be  no  real  reason,  either  psychic 


RELIEF  OF  REPRESSED  EMOTIONS  361 

or  physical.  These  symptoms  which  thus  mysteriously  appear 
are  in  many  instances  but  the  resurrection  of  buried  and  sup- 
posedly dead  fears  and  emotions  which  have  been  long  sub- 
merged beneath  the  level  of  consciousness,  but  which  have 
remained  crystallized  in  the  subconscious  experience  ready  to 
spring  forth  under  favorable  conditions  to  startle  and  plague 
the  mind  that  did  so  long  nourish  and  harbor  them. 

REGRET  AND  SORROW 

Regret  is  the  memory  which  lingers  in  the  mind  of  some  dis- 
agreeable experience  in  the  past,  some  feeling  or  pain  which  we 
know  might  have  been  avoided  had  we  been  more  thoughtful 
or  careful,  and  little  does  the  neurasthenic  pause  to  consider 
how  useless  is  this  demoralizing  regret  —  this  paralyzing  sor- 
row. There  is  but  one  useful  thing  to  remember  of  our  past 
experiences  when  they  are  unpleasant  or  unprofitable,  and  that 
is  the  mere  memory  of  the  mistake  that  it  may  be  avoided  in  the 
future.  Regret  is  translated  into  remorse,  when,  in  the  mistake 
we  have  made,  we  recognize  that  we  have  sinned  against  our 
ideal  —  transgressed  the  laws  of  recognized  ethics.  The  in- 
tensity of  our  remorse  only  goes  to  show  the  degree  of  our 
morality. 

Sorrow  is  selfish  —  highly  selfish,  but  it  is  next  to  impossible 
to  get  average  persons  to  recognize  and  admit  that  this  is  true 
when  they  themselves  are  the  victims.  However  tragic  the 
experience  or  great  the  misfortune,  what.  I  ask.  may  one  hope 
to  gain  by  indulging  in  sorrow,  other  than  increasing  sadness 
and  possibly  despondency  and  melancholy. 

TEMPER   CONTROL 

What  has  been  said  in  this  chapter  relative  to  the  emotional 
elimination  —  to  the  expression  and  relieving  of  the  emotions  — 
must  not  be  construed  as  an  excuse  for  the  manifestation  of 
temper.  Just  because  an  individual  sometimes  feels  better  and 
breathes  easier  after  a  splenic  outburst  in  no  wise  proves  that 
the  final  results  on  either  mind  or  body  of  such  manifestations 
of  anger  are  beneficial :  the  fact  is  they  are  decidedly  del- 
eterious.     There   are   other   more   desirable    and   also   militant 


362  WORRY  AND  NERVOUSNESS 

methods  of  giving  vent  to  one's  feelings  entirely  in  accordance 
with  good  reason  and  sound  judgment,  not  to  say  good  taste. 
The  same  ends  can  be  secured  by  deliberate  and  soberly  con- 
trolled reason.  For  instance,  one  of  your  servants,  employees, 
or  other  subordinate  makes  some  stupid  blunder  that  causes  you 
no  end  of  inconvenience,  and  you  are  tempted  to  rail  out  upon 
him.  Just  stop  for  a  moment  and  reason  with  yourself  regard- 
ing his  opportunities  in  life,  take  into  consideration  the  fact 
that  he  has  not  had  your  opportunities  of  developing  keenness, 
clear-sightedness,  and  a  sense  of  propriety.  In  other  words, 
dismiss  the  whole  matter  with  a  smile,  while  you  repeat  over  in 
your  mind  some  phrase  which  you  keep  handy  in  the  mind  for 
such  occasions,  like  the  following:  "  Well,  if  he  had  my  brains, 
lie  would  have  my  job,"  and  you  will  get  just  as  much  emotional 
relief  and  personal  satisfaction  as  if  you  had  indulged  in  a 
regular  oldtime  blowout. 

SECTARIAN   PSYCHOTHERAPY 

Psychotherapy,  as  practiced  by  some  enthusiasts,  has  become 
a  cult,  a  creed,  the  disciples  of  which  constitute  a  therapeutic 
sect.  To  be  admitted  to  its  brotherhood,  it  is  merely  necessary 
that  the  novice  should  be  converted  to  the  faith,  not  that  he 
should  be  convinced  by  scientific  proof.  If  the  convert  claims 
that  his  new  system  is  followed  by  cures,  he  can  show  none 
more  remarkable  than  those  exhibited  by  hypnotism,  divine 
healing,   Christian   Science,   and  like   systems. 

These  specialized  and  faddish  healing  cults  are  the  outcome 
of  the  general  mystic  tendency  of  modern  times.  Occultism 
and  symbolism  in  art,  music,  literature,  and  the  drama  —  cubism, 
futurism,  modernism,  the  problem  play  —  are  all  suggestions  of 
this  tendency.  On  what  basis  are  we  to  explain  such  phenom- 
ena? Factors  which  influence  the  social  condition,  the  mode 
of  living,  of  great  masses  of  people,  all  have  to  do  with  this 
psychopathic  tendency.  Among  them  we  may  enumerate  the 
strain  of  modern  living,  the  strain  of  the  adaptation  required 
by  rapid  rise  in  social  level  with  its  unaccustomed  demands  and 
new  dissipations,  the  strain  of  the  struggle  of  those  who  have 
not  yet  achieved  their  goal,  and  to  this  we  should  add  the  late- 


RELIEF  OF  REPRESSED  EMOTIOXS  363 

ness  of  marriage  and  the  difficulties  of  living  a  normal,  physio- 
logic, complete  life.  Under  these  circumstances  the  less  stable 
and  weaker  minds  lose  their  moorings.    Dr.  Dercum  says: 

That  which  is  old  and  has  perhaps  been  acquired  slowly,  with  diffi- 
culty and  at  great  cost  is  forgotten.  Truth  is  rejected  for  no  other 
reason  than  that  it  is  old.  New  things  are  accepted  for  no  other 
reason  than  that  they  are  new.  There  is  an  abandonment  of  all 
previous  standards.  The  mind  is  unhinged  and  takes  refuge  in 
mysticism.  The  real  gives  place  to  the  unreal,  the  beautiful  to  the 
unbeautiful,  the  wholesome  facts  of  life  to  the  morbid  untruths  of 
disease ;  actual  experiences  are  belied  by  pathologic  illusions ;  the 
evidences  of  the  senses  are  replaced  by  the  phantasms  of  exhaustion. 
To  the  jaded  and  blase  psychopathic  patient,  to  the  chronic  hysteric, 
psychasthenic,  hypochondriac,  or  what  not,  to  the  patient  who  has 
tried  all  sorts  of  procedures  these  fantastic  therapeutic  teachings 
present  something  new,  something  interesting,  something  pruriently 
exciting.  The  prophecy  can  with  safety  be  ventured  that  these  ex- 
treme views  of  psychotherapy  will  in  due  course  pass  away,  will  in 
due  course  be  a  matter  of  history,  and  will  then  take  their  place  side 
by  side  with  other  mystic  practices,  such  as  animal  magnetism,  mes- 
merism, Braidism,  hypnotism,  metallotherapy,  Perkinsism,  Dowieism, 
Eddyism,  Worcesterism,  divine  healing,  New  Thought,  the  Bergeon 
treatment  of  tuberculosis,  hanging  in  locomotor  ataxia,  and  other 
weird  procedures  that  have  time  and  again  swept  the  earth  in  epi- 
demic form. 

SAXE    PSYCHAXALYSIS 

My  views  of  the  sane  and  practical  applications  of  psychan- 
alysis  are  well  expressed  by  Burrow  in  a  recent  number  of  the 
Journal  of  the  American  Medical  Association: 

The  policy  of  the  psychanalyst  is  a  robust  one,  and  he  outlines  it 
without  mitigation  or  cavil.  Simply  and  directly,  however  con- 
siderately, he  explains  to  the  patient  the  psychologic  meaning  of  his 
disorder  in  accordance  with  the  psychanalytic  interpretation,  and 
informs  him  of  the  bearing  of  faulty  mental  habits  and  adaptations 
on  the  causation  of  nervous  processes.  The  physician  explains  the 
essential  disharmony  at  the  root  of  these  disorders;  the  irrecon- 
cilability of  contending  mental  and  emotional  influences  within  the 
personality,  pointing  out  the  inherent  conflict  thus  embodied  in 
neurotic  disorders.    He  further  explains  that  a  true  adjustment  may 


364  WORRY  AND  NERVOUSNESS 

be  made  only  through  an  honest  recognition  of  the  vital  unconscious 
trends  with  which  his  personality  is  now  blindly  and  inadequately 
contending.  At  the  same  time  he  frankly  tells  the  patient  that  the 
process  through  which  the  requisite  adjustment  is  to  be  made  entails 
difficulty,  discomfort,  and  personal  sacrifice  on  his  part,  and  he  does 
not  disguise  from  the  patient  his  responsibility  in  this  effort  of 
readjustment. 

While  not  unsympathetic  to  the  suffering  of  his  patient,  the  psych- 
analyst  makes  clear  that  his  is  no  maudlin  or  sentimental  sympathy, 
such  as  would  surround  the  patient  with  the  soft  and  ineffective  min- 
istrations of  external  attentions,  but  that  his  sympathy  is  virile  and 
adult  and  allied  to  what  there  is  within  the  man  of  courage  and 
honest  purpose.  And  so  the  psychanalyst  makes  clear  his  position 
that  for  him  "  cure  "  means  a  thorough  and  unflinching  acquaintance 
with  one's  innermost  self,  that  cure  is  the  attainment  of  an  undis- 
torted  vision  of  life  without  regard  to  personal  comfort  or  edifica- 
tion, and  that  the  mind  which  is  torn  with  inner  doubt  and  discord  is 
prepared  to  accept  terms  of  peace  with  itself  only  when  it  has  been 
brought  to  see  things  in  their  unembellished  truth. 

When  the  psychanalyst  has  at  last  divested  the  personality  of  its 
artificial  mantle,  and  views  the  natural  man;  when  we  have  stripped 
away  the  husks  of  pretense  and  have  dared  to  look  unafraid  on  the 
contour  of  the  actual;  what  we  find  universally  to  be  the  purpose, 
the  real  motive  of  all  this  elaborate  and  painstaking  mechanism  of 
insincerity  and  disguise  is  an  ancient  and  indigenous  egotism. 
Egotism  is  the  effort  to  see  things  as  we  would  have  them,  rather 
than  as  they  are.  Egotism  is  therefore  no  respecter  of  truth.  The 
wish  is  its  sole  criterion,  for  egotism  is  allied  with  the  unconscious, 
with  the  primary,  pleasure-principle,  the  original  phase  of  psychic 
life  with  its  immediate,  hallucinated  satisfactions.  It  is  egotism  which 
leads  us  to  choose  what  is  pleasant  in  preference  to  what  is  true.  It 
has  been  wisely  said,  "  the  truth  hurts."  It  is  so  much  easier  to  be 
beguiled  with  flattery  and  blandishments  than  to  subject  oneself  to 
the  searching  light  of  self-criticism. 

Thus  it  is  egotism  that  lures  men  into  the  rosy  path  of  irrespon- 
sibility. To  follow  it,  however,  is  to  take  the  path  that  leads  finally 
beyond  the  bounds  of  organized  society  toward  disintegration  and 
madness,  for  insanity  is  nothing  else  than  the  unmeasured  sway 
within  the  personality  of  this  disorganizing  principle  of  egotism. 

It  is  this  same  egotism  — this  obstinate  "determination  to  see  the 
world  as  it  is  not,  but  only  as  he  wishes  it  to  be"  which  is  the  be- 
setting fallacy  of  the  neurotic  personality.     We  maintain,  however, 


RELIEF  OF  REPRESSED  EMOTIOXS  365 

that  while  not  less  deep-seated  and  obdurate,  the  egotism  of  the 
neurotic  individual  is  somehow  incompatible  with  something  better 
within  him.  He  seems  imbued  with  a  finer  intellectual  insight,  a 
deeper  sensitiveness  to  life's  values.  Some  innate  truth  endows  him 
with  a  higher  moral  criticism,  so  that  instinctively  he  opposes  a  bar- 
rier to  egotism's  sensuous  appeal,  and  so  the  insincerity  and  untruth 
into  which  his  native  egotism  has  decoyed  him  is  to  such  a  personality 
wholly  intolerable,  and  he  experiences  the  intensest  mental  suffering 
in  consequence  of  the  moral  conflict  which  an  enforced  resort  to 
such  artificial  protections  has  occasioned  him.  He  can  no  longer  find 
satisfaction  in  the  popular  appeasements  of  the  body-social,  but  be- 
comes more  and  more  deeply  introverted,  withdrawn  and  inhibited, 
until  at  last  his  life  has  become  so  crippled  and  confined  as  to  be  no 
longer  livable. 

It  is  the  aim  of  the  psychanalyst  to  lead  such  a  personality  out  of 
his  prison  of  repression  and  ineffectiveness  by  means  of  a  patient 
and  honest  study  of  himself.  With  consideration  and  respect  the 
psychanalyst  traces  one  by  one  the  causes  which  have  led  to  his 
isolation  and  repression.  He  leads  the  patient  to  a  gradual  realiza- 
tion of  the  inherent  egotism  —  the  latent  unconscious  wish  — that  has 
lain  back  of  his  symbolic  disguises.  Thus  the  personality  is  led  little 
by  little  to  an  ever-deepening  renunciation  of  the  immediate  pleasure- 
satisfactions  and  to  the  gradual  attainment  of  a  correspondingly 
broad  conscious  adaptation. 

Egotism  is  precisely  the  enemy  of  human  progress  against  which 
the  psychanalyst  levels  his  aim.  Under  whatsoever  sham  egotism 
thinks  itself  most  safely  concealed,  it  is  here  that  the  psychanalyst 
directs  his  attack. 

The  task  of  the  psychanalyst,  therefore,  is  the  readjustment  of 
the  neurotic  patient  through  a  process  of  self-elimination.  It  is  his 
task  to  replace  caprice  with  logic,  emotion  with  reason,  temporary 
satisfaction  with  permanent  truth.  The  psychanalyst  then  takes  his 
stand  on  adult  characterologic  ground.  He  recognizes  that  the 
abnegation  of  immediate  selfhood  is  the  highest  attainment  within 
the  ethical  nature  of  man,  that  the  subversion  of  the  primary  infantile 
pleasure-mode  is  the  supreme  renunciation. 

We  contend  that  since  a  great  part  of  the  beliefs  and  customs  of 
the  community  have  at  heart  the  same  underlying  motive  as  actuates 
the  symptoms  of  the  neurotic  patient  with  his  organic  evasions  and 
substitutions,  namely,  an  inherent  egotism,  the  trend  of  the  psych- 
analyst not  only  aids,  in  its  re-educative  influence,  the  individual, 
but  also  makes  for  a  better  and  a  healthier  community.     For  the 


3/56  WORRY  AND  NERVOUSNESS 

psychanalyst  would  utilize  this  force  resident  in  the  onward  effort 
of  mental  evolution.  We  would  direct  to  better  uses  this  impulse 
of  self-attainment  which  lies  at  the  source  of  the  manifestations 
which  we  call  life,  for  with  the  attainment  of  consciousness  the  pos- 
sibility is  opened  for  converting  this  genetic  life-force  into  a  con- 
structive and  a  purposive  principle.  With  the  gradual  enlarging  of 
consciousness  it  has  become  more  and  more  adapted  to  social  and 
ethical  ends.  Thus  through  the  sublimating  process  of  mental 
growth,  egotism  becomes  diverted  into  self-devotion. 

M  EX T AL   DE-CO X CEXTR ATIO X 

In  another  chapter  we  have  laid  great  emphasis  upon  the 
importance  of  concentration  —  calling  attention  to  the  necessity 
of  cultivating  this  mental  power  as  a  part  of  the  discipline 
and  training  which  is  to  effect  the  cure  of  the  various  nervous 
states.  It  is  equally  important  in  mental  catharsis  —  in  the 
process  of  emotional  elimination  —  that  the  nervous  patient 
should  learn  how  to  reverse  the  process  of  concentration,  learn 
how,  as  it  were,  to  efface  ideas  from  the  mind.  The  substitu- 
tion process  does  not  always  work  well  at  first.  We  teach 
these  patients  to  get  their  mind  off  one  idea  by  getting  in  on 
an  opposite  idea.  I  have  recommended  to  my  patients  the  fol- 
lowing exercise  as  an  aid  in  de-concentration,  that  is,  the  power 
to  shift  the  mind  rapidly  from  one  idea  to  another.  The  ex- 
ercise is  as  follows:  Place  before  the  mind  two  pictures, 
preferably  of  different  colors  or  shading,  such  as  a  country 
landscape  view  and  by  its  side  a  rugged  mountain  view,  or 
any  other  two  pictures  which  may  be  selected  from  any  book 
or  magazine.  The  patient  is  then  instructed  to  concentrate  the 
mind  upon  one  picture,  going  carefully  into  the  study  of  its 
details  and  drawing  upon  the  imagination  at  great  length  in 
working  out  and  developing  all  ideas  associated  with  the  view- 
ing of  the  picture.  This  is  to  be  kept  up  for  a  definite  length 
of  time,  say,  five  minutes,  and  then,  upon  the  striking  of  the 
signal  (in  the  early  practice  of  this  experiment  the  patient  is 
always  assisted  by  the  physician,  the  nurse,  or  some  sympathetic 
member  of  the  family)  the  eye  and  mind  are  quickly  focused 
upon  the  second  picture,  and  for  another  five  minutes  the 
imagination  is  exerted  to  its  utmost  in  developing  the  suggested 


RELIEF  OF  REPRESSED  EMOTIOXS  367 

ideas  in  relation  to  this  picture.  It  is  difficult  to  imagine  the 
amount  of  mental  training  that  is  afforded  by  even  a  short  half- 
hour  of  some  exercise  similar  to  this  one. 

Different  writers  have  suggested  different  sorts  of  exercise 
for  this  particular  purpose,  and  among  others  may  be  men- 
tioned the  following: 

First  exercise :  the  patient  should  place  from  three  to  five 
different  objects  side  by  side  on  a  sheet  of  white  paper,  and 
then,  after  impressing  them  well  on  his  mind,  remove  one  from 
the  paper  while  at  the  same  time  effacing  all  recollection  of  it ; 
when  doing  this  it  is  well  for  him  to  close  the  eyes  and  make 
sure  whether  the  object  in  question  has  been  effaced  from  his 
mind.  This  is  most  important.  He  should  then  do  likewise  with 
a  second  and  third  object,  and  so  on  until  all  of  them  have 
been  removed,  when,  if  this  has  been  well  done,  his  mind  will 
retain  nothing  but  the  impression  of  a  sheet  of  white  paper. 

Second  exercise :  Tell  the  patient  to  imagine  two  or  three 
figures  in  his  mind  and  then  to  efface  them  in  succession; 
when  this  has  been  done,  no  impression  of  a  figure  should  re- 
main on  the  brain. 

Third  exercise:  Put  two  objects  before  the  patient  and  tell 
him,  after  effacing  one  of  them,  to  retain  the  impression  of 
the  other;  this  can  also  be  done  with  two  words,  figures,  or 
phrases. 

Fourth  exercise:  The  patient  should  imagine  in  his  mind  a 
large  figure  —  say  figure  seven  —  and  as  he  thinks  of  this  num- 
ber imagine  that  it  is  becoming  smaller  and  smaller  until  it 
completely  disappears.  He  may  also  imagine  it  as  retreating 
further  and  further  until  no  longer  visible. 

NATURAL    CURES 

It  is  not  to  be  wondered  at  in  the  presence  of  our  intricate 
and  complex  civilization,  that  susceptible  individuals  who  are 
hereditarily  defective  in  the  organization  of  their  nervous 
system  should  break  down  and  go  to  pieces  under  the  simple 
stress  and  strain  of  living.  Nervous  diseases  are  on  the  in- 
crease today  because  of  the  fact  that  there  is  an  increased 
feebleness  of  resistance  to  the  various  acting  causes  such  as 


368  WORRY  AND  NERVOUSNESS 

infections,  visceral  disturbances,  poisons,  and  trauma  —  both 
psychic  and  physical.  Thus  we  see  a  combination  of  heredity, 
environment,,  and  education,  all  designed  to  produce  what  may 
be  rightfully  called  a  neuropathic  constitution,  and  the  more 
we  study  mental  disturbances,  the  more  we  are  forced  to  recog- 
nize the  physical  and  environmental  causes  operating  to  destroy 
the  psychic  equilibrium  and  that  the  nervous  states  are  not 
wholly  psychic  in  origin. 

We  have  so  many  times  spoken  of  the  vast  curative  powers 
and  possibilities  of  suggestion,  reeducation,  and  other  methods 
of  mental  cure,  that  we  are  fearful  the  reader  will  jump  to  the 
conclusion  that  mental  remedial  methods  are  well-nigh  all- 
powerful  ;  and  while  we  would  not  say  anything  to  lessen  the 
reader's  faith  in  mental  medicine  in  the  realms  of  functional 
disorders,  we  would  at  this  time  call  the  reader's  attention  to 
the  fact  that  "  old  Mother  Nature  "  is  a  wonderfully  good  nurse, 
not  to  say  a  wise  and  faithful  physician,  and  that  time  is  the 
element  of  cure  in  a  lot  of  these  nervous  disorders,  some  of 
which,  when  not  too  largely  hereditary  and  not  too  grossly 
aggravated,  show  a  tendency  to  run  a  natural  course  and  get 
well  of  themselves,  sometimes  in  spite  of  numerous  and  aggra- 
vating blunders  in  the  matter  of  bunglesome  treatment. 

SUMMARY   OF   THE    CHAPTER 

1.  Psychanalysis  is  a  new  theory  of  psychotherapy  which  as- 
sumes that  functfonal  nervous  disorders  have  their  origin  in 
some  emotional  stress  or  repression. 

2.  As  a  method,  psychanalysis  consists  in  an  effort  to  redis- 
cover these  emotional  mummies  and  then  to  bring  about  their  full 
confession  and  complete  elimination. 

3.  "  Memory  exploration  "  is  a  method  adopted  for  bringing  to 
light  the  early  repressed,  forgotten,  and  buried  emotions  of  the 
neurotic  patient. 

4.  "  Mental  catharsis  "  is  the  process  of  discovering,  recogniz- 
ing, confessing,  assimilating,  and  eliminating  repressed  and  bur- 
ied emotions. 

5.  Confidential  talks  between  child  and  parent  and  the  adult 
conferences  of  the  confessional  or  the  consulting  room  consti- 
tute indirect  systems  of  psychic  catharsis. 

6.  During  adolescence,  parents  and  teachers  should  literally 
and  liberally  share  the  emotional  life  of  youths  just  emerging 
into  manhood  and  womanhood. 


RELIEF  OF  REPRESSED  EMOTIOXS  369 

7.  It  is  a  great  mistake  to  attribute  all  nervous  disturbances  to 
disorders  in  the  sex  life  of  the  individual.  This  is  the  one  great 
error  of  the  modern  school  of  psychanalysts. 

8.  While  the  matter  of  buried  sex  emotions  may  concern  more 
or  less  the  life  of  every  neurotic,  nevertheless,  they  are  not  the 
exclusive  cause  of  such  troubles. 

9.  In  memory  exploration  self-analysis  is  the  ideal  method. 
Let  the  physician  act  merely  as  a  psychic  guide,  contributing  as 
little  of  his  personality  as  possible  to  the  experiment. 

10.  The  patient's  treatment  program  should  be  so  occupied 
with  recreational,  vocational,  and  therapeutic  procedures  that 
all  morbid  sex  feelings  are  effectively  crowded  out  of  their  emo- 
tional experience. 

11.  The  effort  of  some  psychotherapists  to  put  a  sexual  inter- 
pretation upon  all  dreams  is  absurdly  ridiculous  and  exceed- 
ingly to  be  regretted. 

12.  There  are  psychotherapeutic  properties  and  ethics  which 
should  be  recognized  in  the  treatment  of  a  neurotic  patient  by 
the  physician  who  specializes  in  these  matters. 

13.  Scientific  psychotherapy  should  be  saved  from  this  tend- 
ency toward  sordid  sex  channels.  Mental  medicine  should  en- 
deavor to  escape  the  present  day  tendencies  toward  sex  madness. 

14.  Many  neurotics  are  square  pegs  in  round  holes  —  they  are 
sociological  misfits  —  human  plants  growing  in  the  wrong  cli- 
mate. 

15.  Many  cases  of  emotional  repression  are  found  to  have 
their  origin  in  some  harsh,  shocking,  or  violent  experience  of 
early  childhood. 

16.  Emotions  are  not  purely  physiological  in  origin.  Our 
ideas,  however  awakened,  also  contribute  something  to  our  emo- 
tional feelings. 

17.  "  Memory  ghosts"  are  always  walking  in  the  mind  of  the 
neurotic  patient.  These  patients  are  constantly  tortured  by  re- 
calling their  former  symptoms,  sufferings,  and  psychic  night- 
mares. 

18.  Longing  regrets  and  selfish  sorrow  are  the  bane  of  neuras- 
thenics and  hysterics,  and  contribute  greatly  to  delaying  their 
final  deliverance. 

19.  The  advocacy  of  emotional  catharsis  must  not  be  construed 
as  approval  of  or  excuse  for  the  manifestations  of  anger  and 
uncontrolled  temper. 

20.  Psychotherapy  as  practiced  by  some  modern  enthusiasts 
has  become  a  cult,  a  creed,  a  therapeutic  sect. 

21.  The  nervous  patient  must  learn  both  mental  concentration 
and  de-concentration  and  there  are  numerous  exercises  which 
will  aid  in  both  accomplishments. 


3/0  WORRY  AND  NERVOUSNESS 

22.  In  the  treatment  and  cure  of  the  neuroses,  while  we  give 
clue  credit  to  all  our  modern  psychotherapeutic  methods,  the  fact 
must  not  be  overlooked  that  it  is  "  old  Mother  Nature  "  who  is 
largely  doing  the  real  healing  work. 


CHAPTER  XXIX 
RECREATION  AXD  RELAXATION 

MANY  of  our  nervous  patients  live  in  a  state  of  constant 
muscular  contraction  or  nervous  agitation.  Both  mind 
and  body  seem  to  be  working  under  a  continual  nervous  lash. 
The  vital  powers  are  driven  at  a  ruinous  pace,  while  the  nerv- 
ous energies  are  dissipated  in  a  lavish  and  extravagant  manner ; 
the  energy  granules  of  the  nerves  centers  are  being  used  up  to 
no  useful  purpose.  There  is  a  tremendous  waste  of  fuel  and 
energy  in  these  various  useless  movements  on  the  part  of  the 
human  machine.  It  must  be  admitted  that  many  nervous  per- 
sons, especially  nervous  women,  reach  that  place  where  they 
actually  seem  to  enjoy  this  continual  state  of  nervous  intoxica- 
tion. They  are  never  happy  except  when  they  are  excited  and 
fidgety. 

NERVOUS    EXPLOSIONS 

The  culmination  of  nervous  irritation  and  lack  of  nervous 
control  is  seen  in  the  explosions  and  outbursts  of  acute  anger. 
Both  the  circulatory  and  nervous  systems  are  concerned  in  these 
manifestations  of  nervous  temper.  Not  only  are  the  nerves 
irritated  and  under  loose  control,  but  we  now  know  that  these 
angry  emotions  are  largely  determined  by  certain  changes  in 
the  visceral  circulation.  In  the  initial  state  of  anger  or  passion 
the  face  is  pale,  while  the  small  blood  vessels  of  the  brain  are 
greatly  dilated,  enormously  congested.  The  internal  pressure 
is  greatly  raised:  in  fact,  sudden  death  from  apoplexy,  due 
to  the  rupture  of  a  blood  vessel,  is  not  an  uncommon  result 
of  a  fit  of  anger. 

Anger  represents  the  culmination,  then,  the  climax  of  nerv- 
ousness. During  a  fit  of  temper,  every  function  of  the  body  is 
run  at  an  extravagant  pace,  and  all  its  work  is  carried  on  in  a 

3/i 


372  WORRY  AND  NERVOUSNESS 

wasteful  fashion.  Tears  may  flow  and  saliva  run,  while  all 
the  muscles  of  the  organism  are  in  a  state  of  intensity  and  con- 
traction. This  tenseness  is  also  found  to  pervade  the  sympa- 
thetic nervous  system,  and  as  a  result  all  the  smaller  blood- 
vessels are  oaused  to  contract  down  in  a  sort  of  spasm.  The 
blood-pressure  is  enormously  raised,  the  patient  executes  a  host 
of  useless  movements,  which  may  consist  in  biting  the  finger 
nails,  clinching  the  fists,  stamping  the  floor,  throwing  objects, 
and  giving  other  exhibitions  of  demoralized  and  inefficient 
nervous  control. 

THE    FATIGUE    STATE 

We  cannot  have  long-continued  over-functioning  of  the  nerv- 
ous system  without  having  a  subsequent  and  corresponding 
stage  of  under-functioning;  and  so,  the  fidgety  state  is  sooner 
or  later  followed  by  the  fatigue  state.  The  sufferer  who  is  all 
"  keyed  up,"  high-strung,  nervous,  fidgety,  and  over-active  to- 
day, must  necessarily  tomorrow  or  next  day  begin  to  experi- 
ence unusual  mental  weariness  and  unnatural  physical  fatigue. 
Such  a  patient  will  then  describe  himself  as  feeling  "all  run 
down."  Exactly  so ;  which  only  goes  to  show  that  he  was 
previously  all  wound  up.  Nature  allows  this  nervous  exhaustion 
to  overtake  them  for  the  express  purpose  of  keeping  the  nerves 
from  "  snapping,"  to  prevent  the  "  boilers  from  bursting."  This 
sense  of  nervous  prostration  and  physical  fatigue  which  super- 
venes in  the  case  of  these  excited  and  agitated  creatures  is 
a  great  and  wise  safety  device  —  it  is  an  efficient  life-saver. 

We  should  not  unduly  resist  our  fatigue  and  tired  feelings. 
Having  done  your  best  to  economize  muscular  and  nervous 
expenditure,  if  at  night  you  find  yourself  tired  and  weary,  sim- 
ply reason  like  this :  "  Yes,  I  am  fairly  tired  out  tonight,  but 
that  is  only  natural.  I  will  go  to  bed  and  get  rested.  I  shall 
be  all  right  in  the  morning."  And  this  very  acceptance  of  your 
fatigue  will  rest  you,  more  or  less,  immediately.  We  must 
learn  to  cast  from  us  the  magnification  of  our  weariness  and 
the  emphasis  of  our  fatigue.  There  is  something  decidedly 
wrong  with  one's  nerves  when  everybody  is  constantly  "  get- 
ting on  them."  They  are  highly  diseased  —  abnormally  sensitive. 


RECREATIOX  AXD  RELAX  AT  10  X  373 

THE  MODERN   SPIRIT  OF  RUSH 

A  great  deal  of  the  excitement,  hurly-burly,  and  rush  of 
everyday  life  is  to  no  purpose  whatever.  Even  when  it  is 
necessary  to  make  haste,  let  us  make  it  calmly,  without  excite- 
ment and  needless  exertion.  The  unnatural  and  needless  strain 
of  this  hurry  and  rush  so  contracts  the  muscles  that  they  cannot 
engage  in  rapid  locomotion  without  undue  exertion,  and  conse- 
quently premature  and  unnecessary  fatigue.  In  fact,  some 
people  are  so  hurried,  chronically  rushed,  that  they  cannot  take 
time  to  eat,  to  breathe,  or  to  sleep,  in  a  natural  and  normal 
manner.  A  little  systematic  planning  would  enable  most  of 
them  to  do  a  great  deal  more  work  each  day,  and  to  do  it  with 
one-half  the  expenditure  of  vital  energy. 

Nature  would  do  very  well  for  most  of  us  if  we  would  learn 
to  keep  our  hands  off,  if  we  would  simply  leave  her  unmo- 
lested. We  are  constantly  and  unnecessarily  adding  to  her 
stress  and  strain.  We  are  incessantly  overworking  certain  or- 
gans and  underworking  others.  Everlastingly,  we  are  inject- 
ing unhealthy  impulses  into  the  nervous  regulation  of  our  phys- 
ical forces.  In  fact,  thousands  of  semi-invalids,  if  they  would 
but  learn  to  relax,  to  effect  a  nervous  surrender,  and  then  prac- 
tice the  simple  laws  of  hygiene  with  respect  to  eating,  drinking, 
and  sleeping,  would  experience  a  speedy  and  more  or  less  com- 
plete recovery. 

THE  GOSPEL  OF  RELAXATION 

We  need  to  acquire  more  of  the  play  spirit  of  the  child  who 
can  run  about  and  romp  all  day  without  getting  unnaturally 
tired  in  either  mind  or  body.  We  need  to  practice  relaxation. 
It  seems  especially  necessary  in  this  generation  that  men  and 
women  should  learn  how  to  relax.  Nervous  patients  should 
practice  perfect  relaxation  from  fifteen  minutes  to  half  an 
hour  in  the  middle  of  the  day. 

Most  patients  will  find  it  best  to  begin  the  practice  of  the 
gospel  of  relaxation  in  connection  with  their  daily  recreation 
and  their  regular  rest  and  sleep  at  night.  Learn  to  give  your- 
self entirely  over  to  the  bed  whereon  you  sleep :  do  not  try  to 
hold  yourself  in  the  bed  or   on  the  bed.     If  the   reader  will 


374  WORRY  AND  NERVOUSNESS 

observe  himself  tonight  (unless  he  is  fortunately  one  who  has 
never  forgotten  how,  or  else  has  already  re-learned  how 
to  relax),  he  will  be  surprised  in  noticing  how  continuously  and 
strenuously  he  holds  himself  in  a  certain  position  on  the  bed. 
He  will  find  most  of  his  muscles  cramped,  his  head  held  rigidly 
in  a  certain  position,  the  whole  spinal  column  more  or  less 
rigid;  in  fact,  he  has  taken  up  his  customary  job  of  engaging 
in  hard  muscular  work  in  an  effort  to  go  to  sleep.  In  some 
cases,  the  knees  will  be  found  all  drawn  up,  the  fists  clinched, 
the  chin  flexed,  and  the  jaws  set.  The  entire  physical  picture 
is  one  of  downright  hard  labor. 

Now,  it  will  not  be  an  easy  matter  to  change  this  condition. 
The  gospel  of  relaxation  is  very  easy  to  preach,  but  exceedingly 
hard  to  practice.  Not  only  do  we  have  this  harmful  physical 
tension  on  going  to  bed,  but  it  is  on  retiring  that  some  people 
begin  to  do  their  most  strenuous  mental  work.  The  thoughts 
troop  through  the  mind  in  a  regular  procession.  If  you  can- 
not otherwise  stop  thinking  on  retiring,  success  may  be  achieved 
by  allowing  the  train  of  thought  to  march  on  with  all  its 
energy,  while  you  begin  to  concentrate  the  mind  on  relaxing 
the  body;  and  it  will  usually  be  found  that  your  train  of  thought 
slows  down  just  in  proportion  as  the  muscles  are  relaxed. 
There  is  a  great  deal  of  reciprocal  action  between  mind  and 
body. 

We  have  witnessed  excellent  results  in  insomnia  when  the 
patient's  whole  mind  was  concentrated  on  relaxation.  The  body 
has  been  released  from  its  nervous  tension,  and  the  mind  has 
been  occupied  with  helpful  work  instead  of  being  engaged  in 
harmful,  sleep-destroying,  and  useless  worry. 

In  all  the  animal  world,  man  is  the  only  animal  that  main- 
tains such  incessant  rigidity  of  the  muscles,  and  such  constant 
nervous  tension.  It  is  only  necessary  to  lift  a  sleeping  cat  or 
a  slumbering  babe  to  see  how  completely  relaxed  they  are;  they 
give  over  entirely  their  weight  to  your  supporting  arms.  And 
still,  we  would  not  assert  that  relaxation  alone  is  the  secret  of 
health.  It  is  highly  necessary  that  we  should  have  muscular 
and  nervous  work.  Nerves  and  muscles  must  work  together; 
but  what  we   are   concerned  about  is  the  unnecessary  strain, 


RECREATION  AND  RELAXATION  375 

the  wasteful  and  extravagant  tension  which  accompanies  other- 
wise useful  work,  and  which  so  successfully  invades  even  our 
periods  of  rest  and  sleep. 

RELAXATION    VERSUS   RESISTANCE 

In  overcoming  most  abnormal  states  of  mind  and  nervous 
conditions  of  the  body,  it  will  be  found,  as  a  rule,  that  more 
good  can  be  accomplished  by  relaxation,  by  surrender,  than  by 
resistance,  by  righting.  A  large  percentage  of  those  things 
which  harass  and  vex  us  would  be  robbed  of  their  power  fur- 
ther to  torture  the  soul,  if  we  could  but  become  thoroughly 
reconciled  to  their  presence.  It  is  our  perpetual  resistance  of 
these  annoying  trifles  of  life  that  gives  them  such  great  power 
to  harass  and  disturb  us. 

Many  a  chronic  pain  is  made  worse  by  complaining  about  it 
and  resisting  it.  Had  we  calmly  accepted  the  pain,  as  a  matter 
of  fact,  it  would  have  been  immediately  robbed  of  one-half  its 
torture.  Xow,  we  do  not  make  a  plea  for  over-relaxation,  for 
that  passive  submission  which  shall  rob  us  of  the  power  to 
resist  wrong,  and  the  disposition  to  combat  evil ;  we  are  sim- 
ply here  registering  a  plea  for  nervous  equilibrium,  for  regu- 
lar periods  of  relaxation,  for  periods  of  rest  following  periods 
of  work,  and  further,  to  lessen  the  useless  expenditure  of  en- 
ergy in  needless  stress  and  strain,  while  engaged  in  our  daily 
work. 

RECREATIONAL   CRAZES 

In  addition  to  the  usual  interest  manifested  by  the  public  in 
recreation,  we  observe  certain  periodical  outbreaks  —  veritable 
crazes  —  typified  at  the  present  time  by  the  moving  picture 
craze  on  the  one  hand  and  the  tango-dance  craze  on  the  other. 
The  scientific  study  of  these  recreational  epidemics  has  shed 
considerable  light  upon  the  psychology  of  play  and  the  funda- 
mental basis  of  both  fatigue  and  relaxation.  I  am  convinced 
there  is  a  direct  connection  between  the  enormous  increase  in 
nervous  disorders  and  fatigue-neuroses  of  the  present  time,  and 
the  great  increase  in  the  use  of  narcotics  and  alcoholic  liquors. 
There   exists   the   same   connection  between   our   modern   high 


3;6  WORRY  AXD  NERVOUSNESS 

tension  and  the  more  recent  great  increase  in  our  recreational 
practices.  I  think  there  can  be  traced  a  direct  psychological 
and  physiological  connection  between  these  things. 

A  new  and  unheard  of  interest  has  recently  sprung  up  in 
recreational  play  for  both  the  young  and  the  old.  A  part  of 
the  routine  medical  advice  to  my  adult  neurotic  patients  is:  "  Go 
back  to  play  if  you  would  get  well."  We  have  always  advised 
our  nervous  patients  to  relax,  and  I  am  beginning  to  learn,  in 
recent  years,  that  about  the  only  way  they  can  ever  acceptably 
carry  out  this  bit  of  advice  is  to  "  go  back  to  play/' 

That  this  recreational  propaganda  is  bearing  fruit  is  shown 
by  the  rate  which  the  public  interest  in  our  various  outdoor 
games  and  sports  is  increasing.  The  public  playground  move- 
ment in  the  towns  and  large  cities  throughout  the  country  is 
progressing  by  leaps  and  bounds.  Note  the  rapid  spread  of  the 
boy  scout  movement,  the  camp-fire  girls,  and  the  growing  inter- 
est in  college  athletics.  Even  the  Young  Men's  Christian  Asso- 
ciation has  somewhat  switched  its  religious  activities  from  the 
older  order  into  a  sort  of  recreational  and  athletic  brand  of  re- 
ligion. A  new  interest  is  springing  up  today  in  all  forms  of 
open  air  recreation,  cross  country  tramps,  gardening,  swim- 
ming, and  in  addition  to  the  strenuous  modern  dances,  we  are 
now  experiencing  a  healthy  revival  of  the  older  folk-dancing; 
even  story-telling  is  taken  up  now  as  a  profession,  and  metro- 
politan Sunday  papers  give  up  a  page  to  some  professional 
story-teller. 

Between  three  hundred  and  four  hundred  cities  at  the  present 
time  maintain  public  recreation  playgrounds  to  the  number 
now  approaching  three  thousand,  while  almost  seven  thousand 
play  superintendents  and  play  leaders  are  employed  in  this 
new  profession  which  has  sprung  up  as  a  part  of  our  national 
effort  to  antidote  the  mental  over-concentration  and  the  muscu- 
lar over-contraction  associated  with  the  life  of  our  modern 
civilization.  Chicago  spends  millions  of  dollars  each  year  on 
its  public  playgrounds  and  parks.  The  increase  in  the  number 
of  playgrounds  has  kept  pace  with  the  increase  in  automobiles 
which  have  driven  the  boy  off  the  street,  his  old  playground, 
and  the  upbuilding  of  the  central  portions  of  the  large  cities 


RECREATIOX  AXD  RELAX  ATI  OX  377 

has    deprived    the    lads   of    the    vacant   lot,   their    former   ball 
ground  and  athletic  rendezvous. 

And  now  the  agitation  is  getting  under  good  headway  that 
all  schools  must  have  adequate  playgrounds;  as  someone  has 
said,  "  better  the  playground  without  the  school,  than  the  school 
without  the  playground." 

THE  PSYCHOLOGY  OF  PLAY 

Herbert  Spencer  was  probably  the  first  to  advance  a  theory 
of  play.  It  was  hardly  a  working  theory,  however,  in  that 
he  contended  that  play  was  merely  the  overflow  of  the  super- 
abundant animal  spirits  and  vital  energy  of  youth.  This  seems 
to  us  to  be  merely  a  recognition  of  the  phenomenon  of  play 
rather  than  a  theory  explanatory  of  its  biological  or  psychologi- 
cal significance.  The  later  theory  of  Gross,  advocated  in  his 
works  The  Play  of  Animals,  and  The  Play  of  Men.  sought  to 
account  for  play  on  the  ground  that  children  were  thus  engaged 
in  practicing  their  later  and  more  serious  and  sober  life  pur- 
suits. But  a  later  theory,  and  one  which  to  our  mind  comes 
more  nearly  explaining  the  significance  of  play,  is  that  ad- 
vanced by  Stanley  Hall,  who  seeks  to  connect  the  free  and 
easy  play  of  the  modern  child  with  the  more  serious  and  sober 
pursuits  of  our  ancestors  —  our  more  primitive  progenitors. 

And  so  we  are  told  that  the  spectacle  of  the  young  infant 
suspending  its  weight  while  holding  on  to  some  object,  and  the 
early  instincts  so  commonly  shown  to  climb  ladders,  trees,  or 
anything  else  available,  are  but  racial  mementoes  of  our  ances- 
tral forest  life.  The  hide  and  seek  games,  the  desire  to  convert 
a  blanket  into  a  tent,  the  instinct  for  "shanties" — which  all 
boys  universally  manifest  —  we  are  told  that  these  forms  of 
play  are  but  the  echo  of  remote  ages  when  our  ancestors  so- 
journed in  caves,  lived  in  tents,  or  dwelt  in  the  mountain 
fastness. 

In  this  same  way  the  advocates  of  this  theory  seek  to  explain 
the  strange  and  early  drawings  which  the  young  lad  has  for 
wading,  swimming,  fishing,  boating,  and  other  forms  of  aquatic 
recreation. 

Speed  was  a  vital  requisite  in  past  ages,  both  in  the  chase 


378  WORRY  AX D  NERVOUSNESS 

for  food  and  in  the  ability  to  escape  from  one's  enemies  or  to 
flee  from  danger ;  and  so  it  is  suggested  that  this  is  an  explana- 
tion of  that  racial  heredity  which  is  shown  in  the  joy  with 
which  the  children  engage  in  running,  racing,  coasting,  and 
skating,  and  in  the  modern  speed  mania  of  the  adult  for  motor- 
ing, yachting,  and  airship  flying,  not  to  mention  horse  racing. 

Other  universal  forms  of  play  such  as  "  tag,"  "  pull-away," 
and  "  black  man,"  together  with  mimic  fighting  and  wrestling, 
the  bow  and  arrow,  the  slingshot,  and  the  air  gun,  all  represent 
the  boy  or  the  girl  engaged  in  play  at  those  very  same  pursuits 
and  primitive  activities  which,  in  by-gone  generations,  con- 
stituted the  real  life  work  and  the  sober  employment  of  our 
ancestors  at  different  stages  of  barbarism  and  civilization. 
(Fig.  ii.) 

THE   PURPOSE  OF  PLAY 

It  is  very  evident  that  the  play  of  the  child  is  not  a  prepara- 
tion for  one's  later  life  work.  The  real  work  of  the  world  to- 
day is  found  in  the  school,  the  bank,  the  office,  the  shop,  the 
factory,  and  the  railroad;  but  children  do  not  enthusiastically 
and  instinctively  play  at  these,  neither  are  they  greatly  inter- 
ested in  the  stories  surrounding  these  modern  spheres  of  activ- 
ity. They  are  instinctively  led,  both  in  play  and  tale,  to  the 
forest,  the  stream,  the  camp,  the  cave,  the  hut,  the  forest  hunt- 
ing grounds,  and  the  battlefield,  both  mimic  and  real. 

Dr.  Stanley  Hall,  Dr.  Gulick,  and  Professor  Patrick  have 
repeatedly  called  attention  to  these  newer  ideas  of  play  and 
recreation,  and  I  am  indebted  to  their  numerous  writings  for 
many  of  the  ideas  expressed  in  this  connection ;  particularly  to 
Professor  Patrick,  whose  illuminating  contribution  on  play  and 
recreation  in  The  Popular  Science  Monthly  has  been  so  freely 
drawn  upon  in  the  writing  of  the  latter  part  of  this  chapter. 

Everything  which  has  such  a  vital  and  absorbing  interest 
for  the  boy  has  had  at  one  time  in  our  racial  history  an  actual 
life  and  death  interest  for  mankind. 

Take,  for  instance,  the  jack-knife.  How  many  knives  has  your 
boy  had  and  lost  and  what  rich  joy  there  is  in  every  new  one!  We 
see  how  the  practice  and  preparation  theory  of  play  fails  here.    The 


Fig.  ii.  Young  and  Old  at  Play 


RECREATIOX  AXD  RELAX AT 'I  OX  379 

knife  has  no  significance  in  society  now.  It  has  degenerated  to 
mere  finger-nail  purposes.  But  at  one  time  it  meant  life  in  defence 
and  food  in  offence.  Your  boy's  supreme  interest  in  the  knife  is  a 
latent  memory  of  those  ancient  days.  Those  who  could  use  the 
knife  and  use  it  well,  survived  and  transmitted  this  trait  to  their 
offspring. 

The  same  could  be  said  of  the  sling,  the  bow  and  arrow, 
and  of  sports  like  boxing,  fencing,  fishing,  the  "  camping  out  n 
craze,  etc. 

Consider  the  fascination  of  fishing.  This  is  not  a  practice 
and  preparation  for  the  real  life  of  today,  but  a  reverberation 
of  racial  activities. 

In  a  summer  resort  where  the  writer  was  a  visitor  the  past  sum- 
mer, day  after  day  the  whole  male  population  of  the  hotel  resorted 
to  the  fishing  grounds.  They  paid  two  dollars  and  a  half  a  day  for  a 
guide,  seven  dollars  a  day  for  a  motor-boat,  and  a  cent  and  a  half 
apiece  for  worms.  Surely  a  stranger  uninitiated  into  our  habits  of 
thought  would  have  been  amazed  to  see  these  returning  fishermen 
at  night  indifferently  handing  over  their  catch  to  the  guide.  It 
was  the  fishing  they  desired,  not  the  fish,  and  yet  great  was  their  woe 
when  one  large  fish  was  lost  in  the  act  of  landing. 

Look  at  the  long  line  of  waiting,  patient  fishermen  and  women 
who  line  Chicago's  lake  front  in  every  park  on  Sundays  and 
holidays.  It  is  estimated  by  the  Xew  York  Times  that  on 
Sundays  and  holidays  when  the  weather  is  fine,  25,000  people 
in  Xew  York  City  go  fishing  at  a  minimum  cost  of  one  dollar 
each,  and  of  these  no  doubt,  more  than  95  per  cent  go  for  fun 
and  not  for  the  fish.  (Fig.  11.)  At  some  stage  in  the  history 
of  human  development  fishing  was  without  doubt  a  general 
means  of  subsistence.  Those  who  could  catch  fish  survived 
and  handed  down  this  instinct. 

BASEBALL   AXD  FOOTBALL 

If  we  accept  this  newer  theory  that  the  play  of  the  child  is 
the  spontaneous  and  instinctive  expression  of  the  former  and 
ancient  racial  pursuits  of  his  ancestors,  then  we  can  come  to 
understand  something  about  the  great  popularity  of  baseball 
and  football.     In  this  respect  the  daily  press  is  a  pretty  good 


380  WORRY  AND  NERVOUSNESS 

way  of  judging  the  popular  interest  in  these  outdoor  sports. 
The  morning  of  this  writing  I  examined  a  dozen  copies  of 
metropolitan  dailies,  and  I  found  from  two  to  three  columns 
given  to  politics,  a  column  or  two  to  a  murder  or  suicide,  and 
even  in  the  crisis  of  a  threatened  war  only  five  or  six  columns 
were  devoted  to  the  news  of  the  situation;  but  in  these  same 
papers  and  at  this  same  time,  I  found  from  twelve  to  twenty- 
five  columns  of  matter  devoted  to  baseball,  football,  horse- 
racing,  yachting,  golf,  and  prize-fighting;  far  more  space  de- 
voted to  sports  than  to  the  combined  interests  of  science,  art, 
literature,  religion,  and  politics. 

The  ability  to  throw  a  stone  with  power,  accuracy,  and  speed 
was  at  one  time  in  our  early  civilization  an  important  factor 
in  determining  the  survival  of  the  fittest.  Among  our  early  and 
barbarous  ancestors,  the  man  who  could  pick  up  a  club  and 
strike  with  accuracy  —  hit  with  certainty  and  power  —  was  the 
man  best  fitted  to  survive  in  the  brutal  struggles  of  those  early 
days.  He  not  only  could  better  defend  his  family,  but  was 
also  better  fitted  for  killing  game  and  overcoming  his  enemies. 
And  so  the  ability  to  run  with  speed  and  dodge  with  cunning 
—  the  fleetness  of  foot  and  endurance  of  chase  —  were  all 
vital  factors  in  the  make-up  of  our  ancestors  who  survived  and 
transmitted  these  characteristic  instincts  and  tendencies  to  us, 
their  progeny.  And  today,  when  we  let  go  the  mental  tension, 
relax,  we  find  ourselves  taking  to  these  same  primitive  occu- 
pations as  our  favorite  sport  —  just  like  and  for  the  same  rea- 
sons—  that  a  duck  takes  to  water. 

And  so  in  baseball  we  have  a  game  which  combines  three 
of  the  most  deep-seated  and  ancestral  racial  instincts:  the 
instinct  to  throw  straight,  to  run  fast,  and  to  strike  hard,  not 
to  mention  the  love  of  conquest.  During  long  periods  of  the 
ancestral  life-history  of  our  race,  survival  has  come  to  him  who 
could  throw  the  straightest,  run  the  swiftest,  and  strike  the 
hardest.  To  throw  a  stone  at  something  is  almost  second 
nature  for  a  boy;  throwing  is  a  universal  instinct.  Now  we 
must  admit  that  throwing,  batting,  and  running  are  no  longer 
of  any  practical  use  in  this  civilized  and  advanced  age  of  art, 
science,  and  commerce;  but  they  were  qualifications  of  life  and 


Fig.  12.  He  is  a  Descendant  of  Those  Men  who  Could  Throw 
Straight.   Hit   Hard,  and  Run  Fast 


RECREATION  AND  RELAXATION  381 

death  significance  in  by-gone  ages.  The  baseball  game  revives 
these  old  race  attitudes  and  brings  a  thrill  of  joy  and  cher- 
ished racial  memory  to  both  the  participants  and  spectators. 
Any  one  who  has  ever  held  a  bat  in  hand  and  assumed  the  ex- 
pectant attitude  of  the  batter  knows  the  peculiar  thrill  of  his 
distant  ancestors,  who  in  just  that  attitude,  waited  for  an  ap- 
proaching enemy  and  beat  down  his  foe  with  a  real  war  club, 
whether  his  antagonist  was  man  or  beast,  and  those  who 
assumed  the  best  position,  struck  hardest,  and  aimed  most 
accurately,  survived  and  transmitted  that  instinct  to  their  off- 
spring—  and  baseball  is  the  modernized  and  civilized  expres- 
sion of  these  ancient  racial  characteristics.  The  next  ball  game 
you  attend  take  notice  of  the  star  batter  as  he  takes  his  place 
at  the  plate.  See  him  stand  there,  bat  in  hand,  every  muscle 
tense,  ready  to  strike,  dodge,  jump,  or  run  on  a  moment's  no- 
tice, bat  in  striking  position,  oscillating  in  expectancy  while 
waiting  for  the  ball!  (Fig.  12.)  And  then  the  climax  —  that 
vicious  and  all-powerful  strike,  the  home  run,  and  the  vociferous 
cheering  and  wild  enthusiasm  of  the  vast  throng  of  spectators 
in  the  grand-stand  who  yell  themselves  hoarse  as  did  their 
ancestors  in  olden  times  when  the  gladiator  had  vanquished  the 
beast  or  killed  the  bull  in  the  ancient  arena  ! 

This  instinct  to  throw  belongs  largely  to  boys,  scarcely  ap- 
pearing in  the  case  of  girls.  The  awkward  throw  of  girls,  like 
the  left  arm  throw  of  boys,  is  well  known.  The  plays  of  the 
little  girl  reveal  a  different  set  of  instincts  recalling  the  habits 
of  primitive  woman,  and  so  we  find  that  "  We  are  the  descend- 
ants of  those  men  who  could  throw,  and  those  women  who  loved 
children." 

Football  excites  still  greater  enthusiasm  than  baseball  be- 
cause it  reinstates  and  recalls  still  more  vividly  those  still  more 
primitive  forms  of  ancestral  activity.  Here  we  have  the  face 
to  face  opposition  of  two  trained  and  able  hostile  forces,  the 
rude  and  primitive  physical  shock  of  the  onslaught,  the  barbar- 
ous scramble,  the  cruel  tackle,  the  uncivilized  scrimmage,  the 
savage  melee,  the  fierce  charges  and  collisions,  the  tackling, 
dodging,  and  the  lively  chases  for  goal,  as  for  ancient  cave  of 
safety  —  all  are  a  vivid  reenactment  of  the  life  struggles  of 


382  WORRY  AND  NERVOUSNESS 

the  race  in  by-gone  days.  (Fig.  13.)  It  is  all  a  play-picture  of 
far-away  realities,  and  the  psychology  of  our  whole  play  tend- 
ency is  comprehended  in  the  fact  that  our  instinctive  pursuits 
of  mind  and  body  unfailingly  choose  to  discharge  along  the 
channels  of  the  least  psychic  resistance,  and,  therefore,  our  in- 
stinctive play-efforts  are  productive  of  little  or  no  real  fatigue, 
because  they  operate  along  and  over  long  established  and  well 
initiated  nerve  paths  in  the  brain,  calling  into  play  only  those 
nerve  actions  and  emotions  to  which  our  race  has  long  been 
accustomed. 

THE  PSYCHOLOGY  OF  RELAXATION 

Professor  Patrick  has  so  splendidly  and  concisely  stated  my 
own  views  of  the  psychology  and  physiology  of  fatigue  and 
relaxation,  that  I  cannot  do  better  than  to  quote. 

If  it  could  be  shown  that  the  child  passes  through  the  various 
stages  of  development  that  the  race  passed  through,  this  would 
throw  no  light  on  the  sports  of  men.  Nor  again  does  this  theory 
explain  the  delight  which  children  take  in  their  play  nor  does  it 
make  clear  the  distinction  between  work  and  play.  Why  does  a  boy 
become  so  quickly  fatigued  hoeing  in  the  garden  or  raking  leaves 
when  his  physical  endurance  is  beyond  belief  when  hunting,  fishing, 
or  playing  football?  It  is  commonly  assumed  that  in  the  former 
case  the  fatigue  is  fictitious,  but  this  is  not  the  case,  as  the  results 
of  forced  child  labor  always  show. 

It  is  evident  that  progress  in  civilization  has  depended  upon  the 
development  of  certain  peculiar  forms  of  mental  activity  which  were 
relatively  undeveloped  in  primitive  man.  If  it  be  true  that  these 
forms  of  mental  activity  are  relatively  undeveloped  in  the  child 
and  when  developed  in  the  adult  are  most  susceptible  to  fatigue,  we 
have  at  once  the  key  to  the  whole  problem  of  sport  and  play,  ex- 
plaining why  the  plays  of  children  and  the  sports  of  men  take  the 
form  of  primitive  human  activities. 

Even  in  the  lower  forms  of  animal  life  this  tendency  appears  as 
the  persistent  striving  of  the  organism  toward  an  end,  that  end 
being  usually  some  changed  relation  which  shall  subserve  the  life 
purposes  of  the  individual.  This  striving  has  for  its  subjective  cor- 
relate a  state  which  we  may  characterize  as  tension,  strain,  stress, 
or  effort.  It  is  this  aspect  of  human  behavior  that  constitutes  work 
and  distinguishes  it  from  play.    It  is  the  power  to  hold  oneself  to  a 


RECREATIOX  AXD  RELAXATIOX  383 

given  task  for  the  sake  of  a  given  end,  to  carry  on  an  occupation, 
even  though  it  may  have  ceased  to  be  interesting,  for  the  sake  of 
some  end  to  be  gained  other  than  the  activity  itself.  This  is  work, 
and  it  involves  stress,  strain,  tension,  effort,  endeavor,  concentra- 
tion, application,  and  inhibition,  and  is  unconditionally  the  ground 
of  progress.  It  is  precisely  the  lack  of  this  capacity  for  sustained 
and  persevering  effort  that  characterizes  all  uncivilized  races. 

Play  is  just  the  opposite  and  includes  all  activities  in  which  the 
stress  and  strain  are  absent.  Play  is  self-developing  and  supplies  its 
own  incentive.  It  is  spontaneous  and  pleasant  because  of  the  sense 
of  ease  which  accompanies  it.  Clearly  play  in  this  sense  is  some- 
thing broader  and  more  inclusive  than  those  activities  which  we 
usually  embrace  under  the  term.  It  includes  not  merely  children*s 
plays  and  grown-ups'  sports,  not  only  hunting,  fishing,  boating, 
yachting,  motoring,  flying,  and  all  kinds  of  outing,  not  merely  games 
and  races  and  spectacles  and  tournaments  and  fairs  and  expositions, 
but  also  the  theater,  and  the  opera,  the  enjoyment  of  music  and 
painting  and  poetry,  our  daily  paper  and  our  magazines  and  our 
novels  and  our  romances,  and  for  that  matter,  many  forms  of  so- 
called  work  in  which  the  interest  is  self-developing,  such,  for  in- 
stance, as  gardening  for  pleasure.  Relaxation  or  recreation  would 
be  perhaps  more  fitting  terms  to  designate  this  large  class  of  human 
activities. 

INSTINCTIVE   OR   RACIAL   JOY 

So  we  understand  why  adult  sport  resembles  the  activities  of 
primitive  man.  The  older,  the  more  basal,  the  more  primitive, 
so  to  speak,  the  brain  centers  used  in  our  hours  of  relaxation, 
the  more  complete  our  rest  and  enjoyment.  Just  in  proportion 
as  the  sport  is  primitive,  so  much  greater  is  the  sweet  peace 
which  it  seems  to  bring  to  the  troubled  soul,  simply  because  it 
involves  more  primitive  brain  tracks  and  affords  greater  re- 
lease from  the  strenuous  life.  So  while  we  find  one  hundred 
and  fifty  spectators  at  an  inter-collegiate  debate,  we  find  five 
thousand  at  an  automobile  race,  ten  thousand  at  a  baseball  game, 
twenty  thousand  at  a  great  football  game,  thirty  thousand  at  a 
prize  fight,  and  three  hundred  thousand  at  an  ancient  gladiatorial 
show.  The  nervous  tracts  which  function  in  such  activities  as 
hunting  and  fishing  and  swimming  and  boating  and  camping  and 
in  football  and  baseball  and  golf  and  polo,  in  horse  racing  and 


384  WORRY  AND  NERVOUSNESS 

bull-fighting,  are  deep  worn,  pervious  and  easy.  During  countless 
centuries  the  nerve  currents  have  flowed  through  these  channels. 
Witnessing  these  rude  contests  —  pictures  of  former  ages,  or  tak- 
ing part  in  these  deep-seated,  instinctive  actions,  brings  sweet  rest 
and  refreshment.  "  The  racially  old  is  seized  by  the  individual 
with  ease  and  joy." 

The  game  of  golf  has  a  peculiar  restorative  power  surpassing 
all  medical  or  other  therapeutic  arts.  We  may  be  physically  and 
mentally  weary  from  a  morning's  work.  Despite  the  strenuous 
physical  exertion  of  an  afternoon  at  golf,  our  fatigue  is  less- 
ened, not  increased.  Fresh  air  does  not  explain  it.  It  is  a  re- 
turn to  the  primitive  outdoor  life.  We  stride  over  hill  and 
through  ravine  ;  we  stumble  into  ditches ;  we  carry  a  club  and 
strike  viciously  at  the  balls ;  we  follow  the  ball  with  the  eye 
and  search  for  it  in  the  grass  as  our  forefathers  searched 
for  their  arrows  and  missiles;  we  use  our  legs  and  our  arms; 
we  let  the  nerve  currents  course  through  the  more  ancient  chan- 
nels ;  we  revel  unconsciously  in  latent  memories  and  old  race 
habits  and  come  back  to  our  work  rested,  renewed,  and 
refreshed. 

UNWHOLESOME  PLAY  SUBSTITUTES 

As  the  strenuous  life  increases  in  city  and  country,  there  is 
an  increased  demand  for  relaxation,  whether  in  the  form  of 
baseball  or  football,  horse-racing,  gambling,  automobile  craze, 
auction-bridge  craze,  moving-picture  craze,  or  tango-dancing 
craze.  These  are  all  methods  of  escape  from  the  clutch  of  the 
modern  strenuous  life,  exhibited  in  all  countries,  but  most  no- 
ticeably in  America ;  for  whatever  it  is  that  is  driving  the  hu- 
man race  forward  in  the  path  of  progress  so  rapidly  and 
relentlessly,  seems  to  have  gripped  the  Anglo-Saxon  people 
particularly  hard. 

Even  these  many  forms  of  relaxation  are  not  sufficient  to 
relieve  the  overwrought  brain  centers,  and  so  in  ever-increas- 
ing amounts  we  have  recourse  to  artificial  means  of  relaxation 
through  narcotics,  such  as  alcohol,  tobacco  and  other  drugs. 
Alcohol  by  its  slight  paralysis  of  the  higher  and  later  developed 
brain  centers,  accomplishes  artificially  what  is  effected  naturally 


RECREATION  AND  RELAXATION  385 

by  play  and  sport,  that  is,  it  liberates  the  older,  freer  life  of 
the  emotions  and  the  more  primitive  impulses. 

Thus,  from  this  point  of  view,  the  difficulties  in  regard  to 
children's  play  disappear. 

The  reason  why  children  play  and  why  their  plays  take  reversion- 
ary forms  is  now  evident.  The  higher  brain  centers,  those  making 
work  possible,  are  not  developed.  If  a  child  does  anything,  he  must 
play,  i.  e.,  his  activity  must  take  the  form  prescribed  by  the  brain 
centers  already  developed,  and  these  are  the  old  racial  tracks.  He 
is  equipped  with  a  nervous  mechanism  adequate  for  old  racial  activi- 
ties and  for  the  most  part  with  these  only. 

The  little  girl  hugging  and  nursing  her  doll  is  not  giving  ex- 
pression to  an  instinct  whose  purpose  is  to  prepare  her  for  later 
maternal  duties.  She  is  simply  doing  what  her  mother  and 
her  grandmothers  have  done  since  the  foundation  of  the  world. 
For,  when  the  ancient  cave  man  stood  without,  club  in  hand 
and  rock  missiles  near,  ready  for  the  savage  attack  —  ready 
for  the  test  of  brute  force  which  should  determine  the  fate 
of  his  primitive  family  —  the  woman  of  those  pre-civilized  days 
was  crouching  in  a  dark  corner  of  that  cave  or  hut  dwelling, 
clinging  tightly  to  the  child,  and  figuring  out  the  next  best 
move  to  make  in  case  the  physical  prowess  of  their  natural 
defender  should  fail  in  the  approaching  battle  at  the  threshold 
of  their  primitive  abode.  And  if  our  primitive  mothers  had 
not  thus  planned,  thought,  loved,  and  clung  to  their  babies, 
then  the  little  girl  of  today  who  is  thus  attracted  by  and  devoted 
to  her  dolls,  would  never  have  been  born.  The  child  does  not 
play  because  of  surplus  energy,  for  under  normal  conditions 
all  his  energy  is  expended  in  play;  the  child  is  a  playing 
animal. 

THE  XEW  ERA 

Possibly  the  objection  may  be  made  that  in  this  account  of 
children's  play,  our  attention  has  been  directed  too.  much  to  the 
plays  of  boys  and  that  the  plays  of  girls  have  been  disregarded. 
An  important  distinction  arises  here  to  which  in  this  present 
writing  only  passing  reference  can  be  made.  The  life  of  stress 
and  effort  and  self-direction  of  which  play  is  the  antithesis  is 
essentially  masculine. 


386  WORRY  AND  NERVOUSNESS 

Man  represents  the  centrifugal  motive;  he  stands  for  movement, 
change,  variety,  adaptation ;  for  activity,  tension  and  effort.  Woman 
represents  the  centripetal  motive;  she  stands  for  passivity,  perma- 
nence, stability,  repose,  relaxation,  and  rest.  She  has  greater  com- 
posure and  harmony.  She  has  therefore  less  need  of  the  release 
afforded  by  primitive  forms  of  activity.  Girls,  of  course,  play  and 
their  plays  follow  the  same  laws  as  those  of  boys,  but  yet  in  less 
marked  degree,  while  adult  sports  are  for  the  most  part  masculine 
sports.  Just  at  present  what  we  call  civilization  is  tending  in  the 
direction  of  the  masculine  motive  —  to  variation,  adaptation,  change, 
effort,  stress,  and  work.  That  it  is  producing  anything  remarkable, 
except  in  invention  and  the  mechanic  arts,  is  doubtful. 

The  really  great  things  of  the  world  have  been  produced 
not  with  great  effort,  but  with  great  ease.  The  magnificent 
productions  of  the  age  of  Pericles  in  architecture,  sculpture, 
painting,  and  literature  seems  to  have  been  more  like  the  over- 
flowing of  a  full  vessel  than  like  the  laborious  achievements  of 
hard  work.  But  the  present  age  is  the  age  of  great  effort,  the 
age  of  work,  and  hence  our  growing  demand  for  more  relaxa- 
tion and  rest. 

EDUCATIONAL  VALUE  OF  PLAY 

The  educational  application  of  this  theory  of  play,  presents 
less  difficulties  than  the  older  theories.  It  is  not  necessary  that 
the  child  should  live  through,  live  out,  any  series  of  savage 
stages.  It  is  merely  necessary  that  he  should  be  kept  active 
with  the  mental  and  physical  equipment  that  he  has,  that  work 
should  not  be  too  early  imposed  upon  him  and  that  his  plays 
should  be  so  organized  and  supervised  that,  while  retaining  the 
elementary  form  of  his  instinctive  responses,  they  may  be 
physically,  morally,  and  socially  harmless.  For  instance,  a  boy, 
if  he  is  a  boy,  must  throw.  It  is  just  a  question  of  whether  he 
shall  throw  stones  at  a  cat,  at  a  street  car,  at  little  children,  or 
whether  he  shall  throw  a  curved  ball  to  the  catcher.  The  lat- 
ter is  harmless,  the  former  dangerous.  Again,  a  boy's  instinct 
of  rivalry  is  very  strong.  He  must  do  something  daring,  get 
ahead  pi  some  one,  as  those  of  his  ancestors  who  survived  did 
before  him.  If  a  proper  playground  is  provided,  all  these  things 
may  be  done  without  injury  to  society.     Otherwise  his  instinct 


RECREATION  AND  RELAXATION  387 

is  expended  in  an  effort  to  "  steal  on  Casey's  beat  and  get  away 
with  it."  Again,  at  a  certain  age  the  dancing  instinct  is  devel- 
oped, and  if  the  children  must  be  taught  dancing  then  let  them 
be  taught  the  graceful  and  healthful  folk  dances. 

In  our  modern  cities  supervised  play  has  become  necessary 
for  social  order,  for  the  reason  that  the  old  conditions  of  spon- 
taneous, healthful  play  have  been  taken  away.  Says  Luther 
Burbank : 

Every  child  should  have  mud  pies,  grasshoppers,  water-bugs,  tad- 
poles, frogs,  mud  turtles,  elderberries,  wild  strawberries,  acorns, 
chestnuts,  trees  to  climb,  brooks  to  wade  in,  water  lilies,  woodchucks, 
bats,  bees,  butterflies,  various  animals  to  pet,  hay  fields,  pine  cones, 
rocks  to  roll,  sand,  snakes,  huckleberries,  and  hornets ;  and  any  child 
who  has  been  deprived  of  these  has  been  deprived  of  the  best  part 
of  his  education. 

As  regards  adults,  the  social  applications  of  the  theory  are 
equally  obvious.  There  must  be  large  periods  of  relaxation 
from  the  high  tension  life  of  today.  If  they  are  not  provided 
in  the  form  of  healthful  and  harmless  sports,  there  will  be 
irritability,  abnormal  fatigue  and  anti-social  outbreaks.  There 
will  be  tango-dancing  crazes  and  auction-bridge  crazes  and  there 
will  be  ever-increasing  resort  to  the  temporary,  harmonizing 
effect  of  alcohol,  tobacco,  and  coffee,  not  to  mention  waves 
of  vice  and  crime  and  epidemics  of  immorality. 

THE   SOCIAL    FUNCTION    OF    PLAY 

Even  in  the  life  of  the  family  the  harmonizing  influence  of 
games  is  seen.  The  friction  sometimes  exhibited  among  its 
members,  in  some  cases  taking  the  extreme  form  of  nagging, 
wrangling,  and  quarreling,  is  no  doubt  due  in  large  part  to  the 
fatigue  of  the  higher  brain  centers.  In  such  cases  it  will  often 
be  found  that  participation  in  some  simple  game,  particularly  an 
outdoor  game,  such  as  golf,  tennis,  or  even  croquet,  will  com- 
pletely relieve  the  situation,  bringing  sympathy,  harmony  and 
peace.  In  society,  the  larger  family,  the  same  effect  must 
follow  upon  the  larger  participation  in  healthful  sports.  It 
is  sometimes  a  matter  of  surprise  to  us  in  periods  of  national 
prosperity   when   wages   are   good   and  work   obtainable,   that 


388  WORRY  AND  NERVOUSNESS 

unrest  increases,  together  with  crime  and  insanity.  It  may 
be  because  the  high  tension  with  its  consequent  fatigue  is  not 
relieved.  What  is  needed  is  less  work  and  worry  and  more 
healthful  relaxation.  Worry  is  a  good  example  of  the  high- 
tension  life  that  is  a  part  of  our  civilization.  It  is  very 
wearing,  for  the  reason  that  it  brings  constant  strain  upon 
delicate  and  recently  developed  brain  centers  and  makes  relaxa- 
tion imperative. 

If  we  have  correctly  described  the  theory  of  play  and  the 
psychology  of  relaxation  and  their  relations  to  the  conditions 
of  our  modern  life,  it  will  be  evident  at  once  that  the  need  will 
not  be  supplied  merely  by  providing  more  playgrounds  for 
children  and  more  holidays  and  sports  for  grown-ups,  vital 
as  these  are.  The  difficulty  goes  deeper  and  calls  for  emphasis 
of  still  other  forms  of  relaxation  than  play  and  sport.  There 
are  many  of  these,  such,  for  instance,  as  music,  which  is  one 
of  the  best.  An  ever-ready  and  convenient  form  of  relaxation 
is  the  modern  novel,  in  which  the  attention  is  sustained  object- 
ively as  in  the  chase  or  the  drama,  but  its  value  as  relaxation 
is  greatly  less  than  in  the  old  and  social  story-telling.  Society 
in  all  its  forms  is  a  healthful  means  of  relaxation.  All  valuable 
games  and  sports  are  social  and  the  mere  mingling  with  our 
fellows  lowers  the  mental  stress  and  tension.  Primitive  man 
was  wholly  social  and  survived  only  in  cooperative  groups. 

THE  RELAXATION   OF  RELIGION 

Religion  may  be  mentioned  finally  as  a  mode  of  relaxation 
of  the  highest  value.  Religion  is  letting  go  the  stress  and 
tension  of  the  individual  and  resigning  oneself  to  an  outside 
power,  whether  that  power  be  God  or  the  church.  The  function 
of  religion  in  this  aspect  is  that  of  a  sustainer,  and  religion 
loses  its  usefulness  wholly  if  the  individual,  as  is  often  the 
case,  feels  it  his  duty  to  sustain  his  religion.  His  religion 
must  sustain  him.  Clubs,  societies,  fraternities  of  all  kinds,  exer- 
cise a  similar  function.  The  great  charm  of  all  fraternal  so- 
cieties is  that  they  relieve  the  stress,  the  burden,  the  tension  of 
the  individual  and  shift  the  responsibility  upon  the  society  as 
a  whole.     The  society  is  back  of  him,  to  some  extent  will  do 


RECREATION  AND  RELAXATION  389 

his  thinking  for  him,  decide  moral  questions   for  him,  relieve 
his  worry. 

Just  at  present  we  are  hearing  it  said  that  our  country  has 
gone  "  amusement  mad."  Well,  our  manner  of  life  has  been 
very  strenuous.  The  tension  has  been  high.  Something  was 
bound  to  happen.  Other  forms  of  relaxation  have  failed  us 
just  when  we  needed  them  most  —  particularly  the  diversion 
of  art,  and  the  strength  and  comfort  of  religion. 

SUMMARY   OF   THE    CHAPTER 

1.  Nervous  patients  appear  to  be  under  a  continual  nervous 
lash;  the  vital  powers  are  driven  at  a  ruinous  pace  while  the 
nervous  energies  are  dissipated  in  a  lavish  and  extravagant 
manner. 

2.  Outbursts  of  acute  anger  are  the  culmination  of  nervous 
irritation  and  a  lack  of  self-control. 

3.  The  fidgety  state  is  sooner  or  later  followed  by  the  fatigue 
state,  and  this  is  nature's  plan  to  prevent  the  nerves  "  snapping  " 
and  "  boilers  bursting." 

4.  There  is  something  decidedly  wrong  with  one's  nerves  when 
everybody  is  constantly  "  getting  on  them." 

5.  Do  not  unduly  resist  your  fatigue,  or  make  a  big  fuss  over 
your  tired  feelings. 

6.  Much  of  the  excitement,  hurly-burly,  and  rush  of  our  every- 
day life  is  to  no  practical  purpose  whatever.  Learn  to  make 
haste  calmly. 

7.  We  need  more  of  the  play  spirit  of  the  child  who  can  run 
about  and  romp  all  day  without  getting  unnaturally  fatigued. 

8.  We  need  to  re-learn  the  art  of  relaxation.  It  is  a  doctrine 
easy  to  preach  but  hard  to  practice. 

9.  Practice  letting  go  of  yourself  when  lying  down  and  on  re- 
tiring; fully  relax  the  muscles  and  relieve  the  nerves. 

10.  More  good  to  the  nerves  is  often  accomplished  by  relaxa- 
tion and  surrender  than  by  resistance  and  fighting. 

11.  The  only  way  some  nervous  patients  can  ever  relax  is  to 
"  go  back  to  play  " ;  go  back  to  simple  outdoor  living  with  its 
games  and  recreation. 

12.  Both  the  modern  recreational  craze  and  the  increased  use 
of  narcotics  and  liquors  are  the  result  of  our  high  tension  — 
high  pressure  living. 

13.  Playgrounds,  outdoor  sports,  dancing,  and  athletics  are  all 
recreational  efforts  aimed  at  relaxation. 

14.  The  play  of  the  modern  child  is  an  unconscious  reverting 
to  the  more  serious  and  sober  pursuits  of  our  primitive  ancestors. 


390  WORRY  AND  NERVOUSNESS 

15.  The  game  of  hide  and  seek,  the  instinct  for  tents  and 
"  shanties,"  is  but  an  echo  of  the  racial  living  habits  of  former 
ages. 

16.  The  boy's  love  for  running  and  racing,  and  the  adult  speed 
mania  are  but  reminders  of  an  age  when  life  itself  so  often  de- 
pended upon  fleetness. 

17.  Tag,  pull-away,  and  black  man  are  but  mimic  memories  of 
the  day  when  such  activities  constituted  the  sober  pursuits  of  our 
ancestors. 

18.  The  boy's  fondness  for  the  jack-knife,  and  the  adult  fasci- 
nation for  fishing  are  but  memory  reverberations  of  old  racial 
activities. 

19.  The  popularity  of  baseball  consists  in  the  fact  that  it  re- 
vives in  our  experience  the  three  most  deep-seated  racial  in- 
stincts—  straight  throwing,  fast  running,  and  hard  hitting. 

20.  The  popularity  of  football  is  due  to  the  fact  that  it  presents 
a  more  or  less  savage  face  to  face  combat  between  two  trained 
and  hostile  forces. 

21.  All  of  our  modern  field  sports  and  athletic  pastimes  are  but 
play-pictures  of  far-away  and  distant  ancestral  realities. 

22.  Because  our  recreation  plays  revert  to  ancestral  types  of 
activity,  they  are  therefore  accompanied  by  a  minimum  of  nerv- 
ous fatigue.  They  operate  over  nervous  tracks  long  used  and 
well  established. 

23.  Play  includes  all  those  activities  in  which  stress  and  strain 
are  absent  —  which  are  spontaneous  and  self-developing  in  in- 
terest, supplying  their  own  incentive. 

24.  The  older,  the  more  basal,  the  more  primitive  the  brain 
centers  used  in  our  hours  of  relaxation,  the  more  complete  our 
rest,  relaxation,  and  enjoyment. 

25.  Tennis,  golf,  and  other  outdoor  sports  enable  us.  uncon- 
sciously, to  revel  in  latent  memories  of  old  racial  habits;  and 
thus  we  are  able  to  come  back  to  our  work  rested,  renewed,  and 
refreshed. 

26.  Unwholesome  substitutes  for  outdoor  recreation  are  gam- 
bling, bridge,  moving  pictures,  tango-dancing,  not  to  mention 
waves  of  vice  and  crime  and  epidemics  of  immorality. 

27.  When  these  indoor  substitutes  fail,  the  populace  have  re- 
course to  alcohol  and  other  drug  stimulants  and  narcotics. 

28.  The  little  girl  playing  with  her  doll  is  not  in  preparation 
for  future  maternal  duties,  but  is  instinctively  reverting  to  the 
racial  practices  of  her  ancestors. 

29.  Man  represents  the  centrifugal  motive  in  societv  —  activ- 
itv.  variety  and  change;  woman  represents  the  centripetal  mo- 
tive —  stability,  repose,  and  rest. 

30.  For  educational  purposes  play  must  be  organized  so  as  to 


RECREATION  AND  RELAXATION  391 

retain  its  recreational  value,  while  eliminating  its  undesirable 
and  unsocial  elements. 

31.  This  strenuous  age  demands  not  only  more  playgrounds, 
more  outdoor  sports,  but  also  a  revived  interest  in  music,  art, 
literature,  and  other  recreational  and  intellectual  pursuits. 

32.  Of  all  relaxing  agencies,  religion  is  probably  of  highest 
value ;  that  is,  provided  it  sustains  you  instead  of  you  having  to 
sustain  your  religion. 


CHAPTER  XXX 

THE   PHYSICAL  TREATMENT   OF  THE   NEURAS- 
THENIC STATES  * 

THE  problem  of  treating  the  nervous  patient  is  not  one 
merely  of  improving  the  physical  organism  and  training  the 
mental  powers.  It  is  not  merely  a  matter  of  improving  digestion, 
regulating  exercise,  and  normalizing  the  other  physical  functions 
in  conjunction  with  the  work  of  re-training  the  mental  faculties. 
In  its  largest  sense,  the  treatment  and  management  of  the 
various  nervous  states,  embraces  the  problem  of  teaching  the 
patient  how  to  adjust  himself  to  modern  society,  how  to  relate 
himself  acceptably  and  efficiently  to  the  world  at  large.  It  is 
the  neurasthenic  character  that  must  be  attacked,  it  is  the  in- 
herited tendency  and  cultivated  principle  of  pusillanimity  that 
must  be  combated  and  overcome. 

However  valuable  the  physical  therapeutic  auxiliaries  of 
treatment  and  changed  environment,  nevertheless,  those  who 
depend  upon  these  for  a  cure  will  certainly  fail.  Both  the 
physician  and  the  patient  need  to  be  warned  against  putting 
undue  dependence  upon  the  measures  which  are  recommended 
in  this  chapter.  They  are  valuable  for  certain  purposes  and 
ends,  but  too  much  must  not  be  expected  of  these  physical 
procedures,  which  are  designed  only  to  correct  associated 
abnormal  functional  behavior  in  the  physical  organism. 

GOING   AWAY   FROM    HOME 

In  many  cases  of  nervous  breakdown  and  severe  nervousness, 
it  is  absolutely  necessary   for  the  patient,  man  or  woman,  to 


*  As  touching  personal  hygiene,  but  the  briefest  outline  can  be  at- 
tempted in  this  chapter.  For  a  fuller  discussion  of  these  subjects  the 
reader  is  referred  to  the  author's  work,  The  Science  of  Living,  or  the 
Art  of  Keeping  Well 

392 


Fig.  14.  The  Modern  Eliminating  Bath 


TREATMENT  OF  NEURASTHENIA  393 

get  away  from  home  for  a  while.  Sometimes  this  is  made 
necessary  in  order  to  avoid  some  trivial  irritation  or  other  un- 
wholesome influence  that  may  be  connected  with  the  family 
circle,  the  home  life,  the  business  relations,  etc.  There  may 
be  incompatibility  of  temperament  at  home  which  the  nervous 
patient  is  not  strong  enough  to  rise  above.  We  often  find  that 
even  a  letter  from  home  is  enough  to  bring  on  a  hysterical 
crying  spell,  followed  by  severe  headache.  Neurasthenics  some- 
times feel  that  there  is  no  place  like  home  —  and  that  is  just 
the  reason  they  want  to  go  away  for  awhile.  On  the  other 
hand,  if  the  patient,  even  though  he  remains  at  home,  can 
have  his  energies  enlisted  in  some  altruistic  enterprise,  he  is 
sometimes  able  to  overcome  these  handicaps  of  the  home  en- 
vironment. 

Dubois  has  well  said : 

The  time  has  now  come  to  remind  sufferers  that  the  lending  of  a 
helping  hand  to  others  who  are  similarly  afflicted  is  one  of  the  most 
splendid  and  powerful  aids  to  self-discipline  imaginable.  There  are 
in  every  large  community  hundreds  of  nervously  exhausted  individ- 
uals into  whose  hands  books  like  this  never  come;  and  even  if  they 
did,  they  would  mean  absolutely  nothing  to  them.  These  are  the 
people  —  wretched  mothers  of  numerous  broods,  gaunt  seamstresses, 
ill-favored  specimens  of  both  sexes  from  sweatshop  and  factory, 
shabby  gentlefolk  and  a  heterogeneous  collection  of  human  flotsam 
and  jetsam  —  who  rub  elbows  in  the  ante-rooms  of  clinics  for  nerv- 
ous diseases,  patiently  waiting  for  —  what?  A  word  of  encourage- 
ment, instruction  in  diet  and  hygiene  which,  under  existing  circum- 
stances, they  are  hopelessly  unable  to  follow,  and  a  prescription  for 
medicine  whose  purchase  often  involves  the.  expenditure  of  a  whole 
day's  earnings.  To  such  as  these  is  directed  the  attention  of  every 
reader  whose  ambition  is,  in  the  words  of  Pope,  "  to  endow  a  col- 
lege or  a  cat." 

NEURASTHENIC   HEADACHES 

One  of  the  commonest  causes  of  recurrent  and  self-limited 
headaches  is  fatigue,  whether  bodily,  mental,  or  emotional.  This 
was  long  an  apparent  stumbling-block  in  the  way  of  the  poison 
theory  of  headache,  but  now  it  is  one  of  its  best  illustrations. 
Physiologists    years    ago    discovered    that   what    produced    not 


394  WORRY  AXD  NERVOUSNESS 

merely  the  sensation  but  also  the  fact  of  fatigue,  or  tiredness, 
was  the  accumulation  in  the  muscles  or  nerves  of  the  waste 
products  of  their  own  activities.  Simply  washing  these  out 
with  a  salt  solution  would  start  the  utterly  fatigued  muscle 
contracting  again,  without  any  fresh  nourishment  or  even  a 
period  for  rest.  It  has  become  an  axiom  with  physiologists 
that  fatigue  is  simply  a  form  of  self-poisoning,  or,  as  they 
sonorously  phrase  it,  autointoxication.  One  of  the  reasons  why 
we  are  so  easily  fatigued  when  we  are  already  ill,  or,  as  we 
say,  "  out  of  sorts/'  is  that  our  tissues  are  already  so  saturated 
with  waste-products  or  other  poisons  that  the  slightest  addition 
of  the  fatigue  poisons  is  enough  to  overwhelm  them.  This 
also  explains  why  our  pet  variety  of  headache,  which  we  may 
have  clearly  recognized  to  be  due  to  overwork  or  overstrain  of 
some  sort,  whether  with  eye,  brain,  or  muscles,  is  so  much 
more  easily  brought  on  by  such  comparatively  small  amounts 
of  overexertion  whenever  we  are  already  below  par  and  out 
of  sorts.  People  who  are  "  born  tired,"  who  are  neurasthenic 
and  easily  fatigued  and  "  ached/'  are  probably  in  a  chronic 
state  of  self-poisoning  due  to  some  defect  in  their  body-chem- 
istry. Further,  the  somewhat  greater  frequency  and  acuteness 
of  headache  in  brain-workers  —  although  the  difference  between 
them  and  muscle  workers  in  this  regard  has  been  greatly  ex- 
aggerated—  is  probably  due  in  part  to  the  greater  sensitiveness 
of  their  nerves;  but  more  so  to  the  curious  fact,  discovered 
in  careful  experiments  upon  the  nervous  system,  that  the 
fatigue  products  of  the  nerve  cells  are  the  deadliest  and  most 
powerful  poisons  produced  in  the  human  body.  Hence  some 
brain  workers  can  work  only  a  few  half-hours  a  day,  or  even 
minutes  at  a  time ;  for  instance,  Darwin,  Spencer,  and  Descartes. 

TREATMENT   OF   HEADACHES 

A  method  which  may  sometimes  be  used  advantageously  in 
treating  these  headaches  is  as  follows:  A  rubber  bag  filled 
with  hot  water  and  covered  with  a  moist  flannel,  or  a  fomenta- 
tion, is  applied  to  the  upper  and  back  part  of  the  neck,  while 
a  soft  cheese-cloth  compress  wrung  out  of  cool  or  very  cold 
wTater  is  applied  to  the  face  and  the  top  of  the  head.    The  effect 


b/o 


*  ^  ^  * — . 


- ^ T — ^ 

-£T7- .'. " 


-5 


*    A      -J,     4 


•    .' 


■ 


TREAT  M  EXT  OF  XEURASTHEXIA  395 

of  the  compress  in  relieving  cerebral  congestion  is  greatly  in- 
creased by  the  application  of  the  ice  compress  or  ice-bag  to  the 
front  of  the  neck,  whereby  the  blood-supply  of  the  brain  is 
lessened  by  contraction  of  the  carotid  arteries. 

The  combination  of  heat  and  cold  to  the  head  in  this  manner 
renders  it  possible  to  make  applications  of  heat  to  the  head 
for  a  much  longer  time  than  could  otherwise  be  tolerated,  the 
cold  antidoting  any  ill  effect  which  might  be  produced  by  the 
heat,  while  encouraging  the  good  effects  of  the  application.  The 
author  has  made  use  of  this  application  for  many  years  as  a 
means  of  relieving  certain  forms  of  neurasthenic  headache.  It 
is  exceedingly  useful  also  in  so-called  nervous  headache  accom- 
panied by  marked  congestion  of  the  brain. 

HYDROTHERAPY 

It  is  a  very  easy  matter  for  the  neurasthenic  to  overbathe. 
Sea  voyages  are  often  highly  beneficial,  and  the  diversion  of 
the  seashore  and  the  fresh  salt  air  are  good  for  the  nervous  pa- 
tient, but  remaining  in  the  ocean  water  too  long  only  serves 
to  exhaust  the  reactionary  powers  of  the  patient  and  does  more 
harm  than  good.  It  would  have  been  better  to  have  had  a 
good  salt  bath  or  a  salt  rub  at  home. 

The  electric  light  bath  probably  affords  the  best  known 
means  for  encouraging  elimination  without  unduly  exhausting 
the  patient  by  heat  as  is  so  likely  in  the  Turkish  or  Russian 
baths.  (Fig.  14.)  All  of  these  vigorous  tonic  or  moderately 
long  eliminating  baths  should  be  followed  by  proper  cool  finish- 
ing treatment,  massage,  and  an  hour's  quiet  rest.     (Fig.  15.) 

Other  valuable  baths  in  the  numerous  stages  of  the  various 
nervous  states  may  be  described  as  follows: 

1.  In  low  blood-pressure,  when  there  is  great  lethargy  and 
extreme  fatigue,  it  will  be  found  that  the  ice  bag  to  the  heart 
(fifteen  minutes  at  a  time)  by  stimulating  and  invigorating  that 
organ,  raises  the  blood-pressure,  and  in  measure  relieves  the 
exhaustion.  Cold  baths  (moderately  long)  by  contracting  the 
blood-vessels  of  the  skin,  drive  the  blood  to  the  internal  organs, 
and  thus  raise  the  blood-pressure,  and  relieve  the  feelings  of 
fatigue  and  extreme  weariness.     Copious  water-drinking  also 


396  WORRY  AND  NERVOUSNESS 

temporarily  elevates  the  blood-pressure  and  so  produces  the 
same  effects. 

2.  In  high  tension  and  elevated  blood-pressure  —  the  pre- 
neurasthenic  state  —  the  following  baths  will  be  found  very 
helpful: 

The  neutral  bath.  This  bath  lowers  pressure  by  dilating 
the  vessels  of  the  skin  and  quieting  the  heart.  Try  it  some  time 
when  you  are  restless,  nervous,  fretful,  sleepless,  head  throbbing 
—  take  a  neutral  full  bath,  from  950  to  980  F. 

The  cold  bath.  The  cold  bath,  likewise,  by  the  vigorous  reac- 
tion that  follows  it,  lowers  the  blood-pressure.  Warm  baths 
must  be  continued  for  a  number  of  minutes  in  order  to  lower 
the  blood-pressure,  and  the  neutral  bath  from  fifteen  to  forty- 
five  minutes,  but  cold  baths  must  be  short,  in  order  to  lower  the 
blood-pressure.     The  salt  bath  or  salt  glow  is  doubly  useful. 

Dry  or  moist  heat.  The  sun  bath  is  of  great  value  in  reliev- 
ing high-pressure,  if  properly  taken  (with  cold  cloths  to  the 
head)  as  it  not  only  diverts  blood  to  the  skin,  but  the  "  sunburn  " 
is  a  sort  of  physiological  inflammation  that  causes  the  blood  to 
circulate  freely  in  the  skin  for  days  following  exposure  to  the 
sun's  rays.  Keeping  the  skin  warm  helps  in  lowering  blood- 
pressure.  Hot  fomentations  greatly  dilate  the  blood-vessels  of 
the  skin,  and  so  directly  tend  to  relieve  the  blood  tension. 

The  heating  compress  has  a  desirable  effect  in  lowering  blood- 
pressure,  and  consists  of  several  thicknesses  of  cheese-cloth 
wrung  out  of  cold  water;  apply  to  the  skin  and  cover  with 
oilcloth,  rubber  sheeting,  or  mackintosh,  and  then  wrap  dry 
flannels  around  the  whole  so  securely  that  no  evaporation  can 
take  place.  This  procedure  is  of  great  value  when  applied  to 
the  abdomen  in  portal  congestion  and  chronic  constipation. 

MASSAGE   AND  ELECTRICITY 

Massage  and  manual  Swedish  movements  are  probably  the 
most  universally  used  of  all  physical  therapeutic  methods  in 
the  treatment  of  the  nervous  states.  (Fig.  16.)  We  employ 
light  muscular  massage  even  in  the  "  rest  cure ;  "  and  sometimes, 
in  neurasthenia  and  psychasthenia,  we  begin  light  massage 
treatments  three  times  a  week  long  before  the  patient  is  in 


TREATMENT  OF  NEURASTHENIA  397 

condition  to  react  to  either  electrical  or  hydriatic  treatments.  At 
first  this  massage  is  carried  on  as  a  passive  exercise,  and, 
later,  manual  Swedish  movements  are  added  in  which  the 
patient  cooperates  with  the  nurse  in  the  matter  of  offering 
slight  resistance,  which  is  increased  from  week  to  week  until 
the  patient  shows  evidence  of  being  greatly  strengthened.  And 
while  the  patient  is  receiving  this  treatment,  the  well-trained 
nurse  is  engaged  in  giving  helpful  and  up-lifting  suggestions 
by  encouraging  the  patient  along  in  the  greater  struggle  toward 
mental  mastery  and  nerve  control. 

In  the  case  of  feeble  patients,  bedridden  patients,  who  cannot 
stand  vigorous  exercise,  massage  and  cold  friction  are  very  use- 
ful. The  cold  mitten  friction,  in  which  a  rough  mohair  mit  or 
Turkish  cloth  is  dipped  in  ice  water  and  rubbed  over  one  part 
of  the  body  at  a  time,  is  excellent  for  these  cases.  (See  Fig. 
17.)  Dry  friction  is  also  useful.  Deep  muscle  massage  enor- 
mously increases  the  amount  of  blood  circulating  through  the 
tissues,  and  in  this  way  relieves  the  general  nervous  tension 
and  fatigue  feelings. 

Deep  massage  of  the  abdomen,  rolling  a  small  cannon  ball 
over  the  abdomen  when  lying  down,  or  a  bandage  applied  snugly 
to  the  abdomen,  all  tend  to  raise  blood-pressure  and  thus  indi- 
rectly to  relieve  neurasthenic  fatigue.    Vibration  is  also  valuable. 

Electricity  is  valuable  in  the  treatment  of  neurasthenia  as 
noted  elsewhere,  especially  the  high  frequency  currents  when 
taken  by  the  method  known  as  autocondensation ;  and  it  should 
be  noted  that  the  more  faith  the  patient  has  in  these  electrical 
treatments,  the  more  good  he  seems  to  derive  from  electro- 
therapeutic  procedures. 

PHYSICAL   EXERCISE 

Neurasthenics  need  to  set  their  hands  to  work.  Wood- 
carving,  basket-weaving,  carpet-weaving,  book-binding,  pottery, 
brass-hammering,  and  all  the  other  arts  and  crafts,  which  are 
the  fad  in  some  circles  today,  are  useful  remedies  for  the 
neurasthenic.  Light  employment  occupying  both  hand  and 
mind  is  one  of  the  ideal  treatments  for  the  fastidious  neurotic 
patient.     It  should  be  a  comfort  to  these  nervous  patients  to 


398  WORRY  AND  NERVOUSNESS 

know  that  it  is  not  necessary  to  build  up  a  pugilistic  muscular 
system  in  order  to  get  well ;  in  fact,  many  nervous  patients  are 
greatly  retarded  in  their  recovery  by  the  physical  culture  fads 
which  lead  them  to  over-do  physically.  A  reasonable  amount 
of  open  air  exercise  is  desirable  and  will  be  found  most  bene- 
ficial when  carried  on  along  the  lines  of  some  recreational  sport 
in  which  the  patient  has  agreeable  company.  Long  solitary 
cross  country  walks  are  not  the  best  way  for  the  nervous 
patient  to  get  his  outdoor  exercise. 

Active  physical  exercise,  to  the  point  of  gentle  perspiration, 
brings  a  large  amount  of  blood  to  the  muscles.  It  dilates  the 
vessels  of  the  skin,  producing  a  ruddy  glow,  the  same  as  alcohol, 
only  this  dilation  is  even  more  permanent  and  is  not  followed 
by  an  undesirable  reaction.  Walking,  riding,  rowing,  running, 
swimming,  gymnasium  work,  and  all  forms  of  exercise,  pre- 
ferably those  in  the  open  air,  with  the  clothing  loose  and  free, 
are  all  most  powerful  agents  in  lowering  blood-pressure,  and 
should  be  intelligently  and  systematically  utilized  by  all  mod- 
erately high-pressure  victims.  Passive  exercise  always  lowers 
the  blood-pressure  from  the  very  beginning. 

"  EURHYTIIMICS  " 

If  it  be  true,  as  people  of  foreign  climes  often  assert,  that 
this  is  the  most  nerve-shattering  country  in  the  family  of  civ- 
ilized nations,  the  gospel  of  Jaques-Dalcroze  should  be  one  for 
us.  Neurasthenia,  this  innovator  asserts,  "  is  often  nothing  else 
than  intellectual  confusion  produced  by  the  inability  of  the 
nervous  system  to  obtain  from  the  muscular  system  regular 
obedience  to  the  order  from  the  brain."  The  cure  is  a  re- 
establishment  of  "  rhythmic  order,"  and  this  is  the  end  and  aim 
of  his  system  of  "  Eurhythmies,"  which  is  defined  as  "  mental 
training  to  secure  perfect  self-control  so  that  the  body  obeys 
the  dictates  of  the  brain."  This  is  obtained  with  the  aid  of 
music,  and  its  efficacy  is  such  that  "  all  ugliness,  even  moral  per- 
version itself,"  which  is  a  violation  of  rhythmic  order,  is  ex- 
pected to  yield  to  the  stimulus. 

The  mystery  of  this  new  system  was  revealed  to  Jaques- 
Dalcroze  in  a  very  simple  way.    He  discovered  that  his  students 


X 


TREATMENT  OF  NEURASTHENIA  399 

of  music  were  able  to  sing  more  accurately  if  they  were  allowed 
to  beat  time  with  their  own  hands.  He  saw,  therefore,  "  an 
intimate  relation  between  physical  gesture  and  musical  con- 
sciousness." So  he  invented  a  number  of  gesture-songs.  Then 
he  turned  his  attention  to  rhythm  itself,  "  realizing  that  it  is 
the  basis  not  only  of  all  music,  but  of  all  art,  and  indeed  of 
life  itself."  Music,  however,  is  the  one  art  that  u  most  perfectly 
expresses  every  variety  of  rhythm,  and  which  has  the  most 
intimate  effect  upon  the  physical  sensations  and  spiritual  emo- 
tions."   Hence: 

By  a  series  of  physical  movements  and  gestures  which  "  realize  " 
rhythm,  the  pupils  are  led  on  to  a  stage  when  their  subconsciousness 
is  stored,  as  it  were,  with  rhythmic  melody  and  images,  so  that  at 
last  they  gain  a  joyous  liberty  of  physical  expression  and  are  able 
to  express  not  only  the  greatest  masterpiece  of  music  as  translated 
through  their  own  emotions,  but  also  in  rhythmical  dances  to  ex- 
press all  that  is  highest  and  most  beautiful  in  their  own  individuality. 
The  whole  object  indeed  of  Eurhythmies  is  to  draw  out  the  in- 
dividuality of  the  pupils,  to  make  them  realize  themselves,  and  to 
enable  them  to  express  their  own  emotions  in  a  rhythmic  way.  "  It 
is  a  fact,"  says  Jaques-Dalcroze,  "  that  very  young  children  taught  by 
my  method  invent  quite  naturally  physical  rhythms  such  as  would 
have  occurred  to  very  few  professional  musicians." 

It  is  only  recently  that  the  meaning  of  rhythm  has  been 
realized,  though  it  has  been  dimly  perceived  throughout  all  the 
ages.  It  is  the  ordered  movement  that  runs,  as  it  were,  through 
all  beauty.  It  is  to  be  found  in  the  wind  that  chases  sunlight 
and  shadows  across  the  fields,  in  the  ebb  and  flow  of  the  sea, 
in  the  revolution  of  the  planets,  in  the  sweeping  lines  of 
mountains  and  valleys,  in  the  windings  of  rivers,  in  the  heart- 
throbs of  humanity,  in  all  artistic  expression,  in  the  order 
of  life  itself.  It  has  been  most  clearly  revealed  in  music,  which 
by  rhythm  may  stir  the  highest  emotions  of  men  and  women. 
Rhythm  and  vibration  in  music  are  the  basis  of  life.  Where 
there  is  rhythm  there  is  order,  and  where  rhythm  is  lacking, 
there  is  no  order.  Jaques-Dalcroze  feels  confident  that  a  time 
will  come  when  music  will  be  applied  in  the  broader  general 
sense  to  education,  physical  as  well  as  mental.     He  is  working 


4oo  WORRY  AXD  NERVOUSNESS 

along  this  principle,  and  his  system  of  "  Eurhythmies,"  which 
has  many  thousands  of  students  in  Germany,  Scandinavia, 
Russia,  Switzerland,  England,  and  elsewhere,  "  is  likely  to 
revolutionize  all  methods  of  physical  and  mental  culture.  It  is  a 
training  in  the  joyous  liberty  of  the  body  and  brain,  governed 
by  the  deepest  laws  of  beauty." 

WORK  VERSUS  REST 

I  have  largely  given  up  the  practice  of  the  "  rest  cure  "  in 
the  treatment  of  neurasthenia  and  the  other  nervous  states, 
except  in  certain  cases  of  hysteria ;  in  fact,  I  have  come  to  look 
upon  isolation  of  these  nervous  patients  as  highly  undesirable. 
My  only  exception  to  this  rule  is  in  the  case  of  those  neurotics 
who  are  really  the  victims  of  a  nervous  exhaustion  —  a  nervous 
breakdown  —  who  are  already  confined  to  the  bed,  and  in  these 
cases  I  seek  to  overcome  this  isolation  with  proper  home  or 
institutional  treatment,  and  to  surround  them  with  cheerful  and 
helpful  nurses,  employing  proper  feeding  and  massage  in  con- 
nection with  this  modified  "  rest  cure  "  regime. 

And  so  I  am  averse  to  putting  the  average  neurasthenic  to 
bed  and  "  stuffing  "  him  while  he  indulges  in  the  "  rest  cure." 
One  has  to  do  it  occasionally  with  those  patients  whose  neuro- 
muscular tone  is  very  low,  but  in  all  other  cases,  I  am  decidely 
opposed  to  it.  I  prefer  to  institute  a  regular  regime  of  mental 
and  physical  training;  a  definite  hour  for  a  tonic  bath,  another 
for  resistance  exercise  or  massage,  for  reading  or  being  read  to, 
for  taking  food,  and  for  resting,  will  help  to  occupy  the  time, 
and  will  also  make  the  patient  feel  that  every  effort  is  being 
made  to  restore  him  to  health.  "  Employment  and  hardships 
prevent  melancholy,"  so  said  the  wise  Samuel  Johnson.  Neuras- 
thenics take  their  symptoms  and  themselves  most  seriously,  and 
sometimes  it  has  an  excellent  moral  effect  upon  them  in  the  early 
days  of  treatment  to  pay  considerable  attention  to  their  symp- 
toms. Moreover,  such  symptomatic  treatment  is  bound  to  relieve 
some  of  their  miseries,  and  this  relief  can  be  used  as  an  example 
of  the  way  in  which  all  their  symptoms  will  disappear,  and 
in  this  way  their  nervousness  is  gradually  overcome.  If  you 
are  able  to  instill  into  the  neurasthene's  soul  the  element  of 


T  RE  ATM  EXT  OF  XEURASTHEXIA  401 

hope,  you  have  gone  a  long  way  toward  making  him  well, 
even  though  he  has  got  into  the  hypochondriacal  stage  of  his 
disorder.  Addison  says,  "  Cheerfulness  is  the  best  promoter  of 
health  and  is  as  friendly  to  the  mind  as  to  the  body." 

NATURAL   SLEEP 

When  you  are  unable  to  sleep  you  must  not  work  yourself 
up  into  a  feeling  of  resentment  and  anger  at  your  inability  to 
slumber,  but  rather  let  the  mind  be  concentrated  upon  the  thought 
that  you  will  rest  in  spite  of  your  insomnia  and  quite  often 
when  the  mind  is  taken  off  of  sleep  and  concentrated  upon 
rest,  then  sleep  gracefully  comes  even  though  it  resisted  all 
your  former  efforts  to  woo  and  win  it. 

Rest  itself  is  an  important  essential  in  the  treatment  and 
cure  of  neurasthenia,  and  I  have  seen  many  a  patient  made 
worse  from  being  advised  to  start  out  in  his  weakened  condition 
on  a  trip  to  Europe  or  on  some  other  taxing  journey,  when  he 
would  have  been  a  great  deal  more  benefited  by  staying  at  home 
and  resting  several  hours  a  day  on  the  front  porch.  Turn  your 
vacation  into  a  "nerve  cure." 

One  of  the  worst  features  of  the  neurasthene's  rest  is  the 
sometimes  terrorizing  dreams  which,  to  the  patient,  seem  to 
keep  up  all  night  long,  greatly  disturbing  the  rest  and  sleep. 
They  sometimes  awake  from  these  dreams  with  a  palpitating 
heart,  quaking  limbs,  while  they  are  copiously  bathed  in  perspira- 
tion ;  and  all  this  is  but  a  picture  of  the  relaxed  and  disor- 
dered condition  of  the  nervous  system. 

It  would  be  a  good  plan  for  these  insomniacs  to  avoid  all 
naps  in  the  day  time,  even  cat-naps.  They  had  better  try 
and  keep  themselves  awake  and  in  this  way  make  for  sounder 
sleep  at  night.  The  bedroom  should  be  selected  with  a  view  to 
coolness  and  airiness.  The  bed  should  not  be  too  soft  and 
while  the  covers  are  warm,  they  should  be  light  weight.  In 
some  cases  if  it  can  be  conveniently  arranged,  outdoor  sleeping 
will  be  found  highly  beneficial. 

In  the  winter,  if  the  feet  are  cold  at  bedtime,  hot  foot  baths 
should  be  taken  just  before  retiring,  or  a  hot  water  bottle  can 
be  placed  at  the  foot  of  the  bed.     Some  patients  have  found 


402  WORRY  AND  NERVOUSNESS 

it  a  good  plan  as  a  temporary  relief  from  insomnia,  to  take  a 
glass  of  hot  milk  or  hot  malted  milk  just  on  retiring. 

FOODS    AND    DIET 

We  have  two  great  classes  of  neurasthenics  and  nervous 
sufferers:  first,  those  who  are  in  apparent  good  physical  health, 
well-nourished,  in  good  flesh,  and  in  some  instances  even  over 
weight.  These  patients  usually  enjoy  pretty  fair  digestion 
and  complain  very  little  of  stomach  trouble  unless  it  may  be  occa- 
sionally gas  on  the  bowels  or  more  or  less  constipation.  In 
behalf  of  this  class  we  have  need  to  offer  very  few  suggestions 
in  the  matter  of  diet.  They  are  usually  blessed  with  a  fair  de- 
gree of  appetite  and  are  able  to  digest  and  assimilate  their  food 
with  very  little  difficulty. 

The  other  class  of  neurasthenics  is  represented  by  the  ema- 
ciated, run-down  patient,  suffering  from  digestive  troubles, 
some  real  and  some  imaginary,  and  it  is  this  class  that  calls 
upon  us  for  advice  in  regard  to  foods,  diet,  and  digestion.  And 
right  in  this  connection  I  want  to  lift  a  warning  voice  against 
the  process  of  superalimentation,  as  commonly  practiced  on 
these  patients.  This  senseless  cramming  and  over-feeding  of 
these  nervously  deranged  and  digestively  disordered  sufferers 
is  highly  injurious  and  wholly  uncalled  for.  We  should  pay 
attention  to  the  more  fundamental  duty  of  developing  the 
patient's  appetite  and  not  merely  resort  to  this  therapeutic 
gormandizing  which  in  many  cases,  does  more  harm  than 
good. 

First  and  foremost  let  me  warn  all  neurasthenics  away  from 
dietetic  fads.  The  impressionable  neurasthene  is  prone  to  take 
up  with  any  and  every  faddish  dietetic  system  which  he  may 
read  of  or  hear  about.  The  patient  should  learn  that  it  is 
not  necessary  to  discover  some  new  patent  food  or  other 
high-priced  edible  in  order  to  be  able  to  get  over  his  digestive 
difficulties.  The  neurasthenic  will  do  well  to  discontinue  all 
these  experiments  in  the  dietetic  realm  and  make  up  his  mind 
to  begin  the  early  enjoyment  and  successful  digestion  of  com- 
mon, ordinary  foods  which  are  easily  prepared  and  which 
can  be  obtained  without  great  expense.     The  various  exclusive 


TREAT M EXT  OF  NEURASTHENIA  403 

diet  systems  such  as  the  meat  diets,  milk  diets,  raw  food  diets, 
even  the  exclusive  vegetarian  diets  which  deny  us  the  use  of 
milk  and  eggs  —  the  two  most  valuable  articles  of  diet  for  a 
debilitated  and  dyspeptic  neurasthenic  —  should  be  discarded. 

CALORIES  REQUIRED 

The  important  thing  is  that  the  nervous  patient  of  this  class 
should  have  an  abundance  of  food,  varied  in  character,  and  that 
it  should  be  well-cooked,  tastily  served;  and  well  masticated, 
but  do  not  think  about  dietetics  at  meal  time,  keep  the  mind  off 
your  stomach. 

I  find  that  many  patients  in  their  efforts  at  over-feeding 
have  greatly  over-taxed  their  nerve  power  and  the  capacity  of 
their  digestive  system,  and  so  they  fare  better  and  begin  to  gain 
in  weight  when  the  quantity  of  food  taken  is  greatly  reduced. 
I  have  my  patients,  after  their  meal  is  finished,  make  a  note 
of  what  they  have  eaten  and  then  make  weekly  reports  to  me. 
In  this  way  I  am  able  to  judge  the  number  of  calories  eaten 
each  day,  and  often  I  find  that  patients  who  have  been  suffering 
the  terrors  of  nervous  dyspepsia  trying  to  assimilate  3000 
or  4000  calories  a  day  begin  to  improve  and  put  on  flesh  imme- 
diately their  rations  are  reduced,  say  to  2000  calories  in  twenty- 
four  hours. 

When  I  find  it  impossible  to  persuade  the  patient  to  take 
the  amount  of  food  required,  or  when  after  their  diet  has  been 
reduced  as  first  suggested,  they  complain  of  faintness  and  all- 
gone  feelings  in  the  stomach  between  meals,  then  I  recommend 
that  the  regular  diet  be  supplemented  by  egg-nogs  made  in  the 
following  manner :  Beat  up  one  whole  egg,  separately,  add  to 
a  large  glass  of  cold  milk  which  has  been  sweetened  with 
one  or  two  teaspoonfuls  of  sugar  and  flavored  with  a  few 
drops  of  vanilla.  In  this  way  a  patient  can  take  from  200  to 
300  calories  in  addition  to  the  regulation  diet.  These  egg-nogs 
are  very  easy  of  digestion.  Some  patients  prefer  to  have  a 
little  salt  added  to  this  egg-nog. 

STARCHES   AND  VEGETABLES 

Many  of  these  patients  find  some  difficulty  in  digesting  starchy 
foods  and  should  therefore  have  all  articles  of  diet  belonging 


404  WORRY  AND  NERVOUSNESS 

to  this  class  well-cooked  —  thoroughly  baked.  They  will  find 
it  well  to  choose  their  starchy  foods  from  the  list  including 
baked  potatoes,  well-toasted  bread,  the  toasted  flake  breakfast 
foods,  etc.  Many  of  these  patients  are  also  greatly  troubled  with 
gas  when  they  eat  the  coarser  vegetables  which  are  rich  in 
cellulose,  such  as  turnips,  celery,  carrots,  cabbage,  and  radishes. 
The  neurotic  patient  must  be  warned  against  getting  fictitious 
and  faddish  disorders  in  his  digestive  tract.  I  have  found  that 
these  patients  have  a  great  tendency  to  get  imaginary  cases  of 
dilated  stomach,  cnteroptosis.  etc.,  not  to  mention  displacement 
of  the  kidneys  and  other  organs.  And  so  from  time  to  time 
we  have  various  medical  and  surgical  fads  connected  with  both 
the  cause  and  the  cure  of  nervous  dyspepsia. 

DIETETIC   SUGGESTIONS 

The  diet  should  include  a  liberal  supply  of  cereals,  fats,  fruits, 
and  vegetables,  and  a  moderate  quantity  of  nuts;  milk  and  eggs 
in  abundance,  especially  if  the  patient  is  eating  a  small  amount 
of  meat.  Then  there  are  the  vegetables  which  afford  variety 
to  the  diet,  and  in  some  cases  give  sufficient  bulk  to  stimulate 
peristalsis  in  the  intestinal  canal,  thus  preventing  constipation 
and  all  the  ill  effects  which  follow  in  its  train.  Potatoes  are 
especially  valuable  because  of  the  large  amount  of  alkaline 
salts  they  contain,  which  neutralize  the  acid  secretions  of  the 
body.  Neurasthenics  in  general  would  do  well  to  make  potatoes 
and  green  vegetables  staple  articles  of  diet.  Cereals  as  well 
as  meats  tend  to  produce  an  acid  state  of  the  body  fluids,  a  con- 
dition which  aggravates  insomnia  and  other  morbid  conditions 
from  which  nervous  patients  suffer. 

Buttermilk  may  be  used  to  advantage  by  those  persons  with 
whom  it  does  not  disagree ;  particularly  those  buttermilks  which 
are  made  from  a  vigorous  culture  of  bacillus  Bulgarius,  a 
bacillus  which  thrives  in  the  large  intestine  and  tends  to  over- 
come those  baccilli  which,  in  the  colon,  bring  about  putrefaction 
and  the  consequent  production  of  maleficent  toxins. 

The  diet  for  the  nervous  patient  should  also  largely  exclude 
spices  and  condiments  of  all  kinds.  Pepper,  mustard,  horse- 
radish, cayenne,  capsicum  and  other  similar  substances  derange 


TREATMENT  OF  NEURASTHENIA  405 

the    digestion    by    over-irritating    the    delicate    linings    of    the 
stomach  and  intestines. 

AUTOINTOXICATION 

The  chief  source  of  the  poisons  produced  within  the  body 
is  the  colon.  Here,  unless  intestinal  activity  is  normal  —  and 
it  seldom  is  normal  —  large  masses  of  undigested  foodstuffs 
collect  and  undergo  putrefaction,  giving  off  mischievous  toxins 
that  are  absorbed  into  the  circulation  and  carried  to  every  part 
of  the  system,  where  they  exercise  a  paralyzing  influence  on 
both  muscle  and  nerve  tissue.  The  very  food  we  eat  gives  rise 
under  certain  conditions  to  the  most  malicious  of  poisons,  while 
the  nerves  and  muscular  action  give  off  waste  products  that  are 
equally  as  toxic  in  character. 

The  ideal  diet,  then,  for  the  neurasthenic  —  as,  indeed,  for 
any  other  person  for  that  matter  —  is  one  that  will  produce 
a  minimum  amount  of  poisons  and  that  will  so  increase  intestinal 
activity  that  foodstuffs  will  not  collect  and  undergo  putrefaction 
and  give  off  toxins,  which,  when  taken  into  the  circulation, 
paralyze  muscle  and  nerve  tissues.  Such  a  diet  is  not  difficult 
to  provide  for  one's  self,  for  it  is  a  simple  diet  based  upon  the 
known  laws  of  dietetics  coupled  with  the  patient's  experience. 

DAILY    OUTLINE    OF   TREATMENT 

As  a  suggestion  regarding  the  physical  treatment  of  neuras- 
thenia, I  will  cite  the  prescription  I  wrote  today  for  one  week's 
treatment  of  a  typical  neurasthene: 

First  day:  Fomentations  to  the  spine  and  arc  light  to  the 
abdomen.  Hot  foot  bath  followed  by  cold  mitten  friction. 
High  frequency  spark  to  the  back  of  the  neck  for  three  minutes. 

Second  day:  Arc  light  and  ice  rub  to  the  liver  for  ten  minutes. 
Full  Galvanic  or  Sinusoidal  bath,  followed  by  a  light  full 
massage. 

Third  day:  Local  galvanism  to  abdomen  and  spine.  Short 
electric  light  bath  followed  by  cold  mitten  friction.  Vibrating 
chair  for  five  minutes. 

Fourth  day:  Hot  and  cold  (alternate)  to  the  spine.  Salt 
glow  and  rose  spray  followed  by  centripetal  oil  rub. 


406  WORRY  AND  NERVOUSNESS 

Fifth  day:  Neurasthenic  spray  flashes  (hot,  1280,  15-30 
second;  cold  6o°,  30-60  second,  instantaneous  alternations)  five 
to  ten  minutes.  Full  massage.  High  frequency  electricity  by 
autocondensation,  ten  minutes. 

Sixth  day:  Vibration  to  the  spine  with  sinusoidal  electricity 
to  the  abdomen  (short  application).  Electric  light  bath  followed 
by  rose  spray  and  an  oil  rub. 

MEDICAL    AND    SURGICAL    FADS 

Greatly  to  be  pitied  is  the  nervous  patient  who  falls  into  the 
hands  of  the  physician  or  surgeon  who  has  a  fad.  He  is  destined 
to  be  dieted,  sweated,  electrified,  stretched,  and  rubbed,  or  to 
have  his  supposedly  dislocated  back  bones  forcibly  put  in  place ; 
or,  if  a  woman,  perhaps  some  trifling  pelvic  disorder  will  be 
treated  and  cauterized,  or  it  may  be  that  some  other  new  and 
wondrous  cure-all  will  be  tried  out  upon  them  and  fortunate 
indeed  are  the  patients  if,  having  suffered  these  many  things 
from  many  physicians,  they  find  themselves  ready  to  begin 
scientific  psychotherapy,  no  worse  for  their  various  adventures 
in  the  therapeutic  and  medical  wonderland. 

In  this  connection  I  want  to  say  a  word  about  surgery  and 
its  relation  to  neurasthenics  —  and  since  that  is  my  chief  pro- 
fessional pursuit,  and  not  psychotherapy,  I  feel  competent 
to  speak  with  some  degree  of  assurance  —  and  after  years 
of  observation  I  feel  it  my  duty  to  express  what  I  am  about  to 
say  on  this  subject. 

There  constantly  come  under  my  supervision  nervous  patients 
who  believe  they  are  in  need  of  some  major  surgical  operation. 
Some  doctor  at  some  time  has  dropped  a  careless  word  or  hint 
regarding  the  possibility  of  tumors,  cancers,  floating  kidneys, 
intestinal  kinks,  prolapsed  stomach,  or  misplaced  uterus.  These 
ideas  were  immediately  seized  upon  by  the  diseased  mind  of  the 
patients,  and  all  their  miseries  from  that  time  on  were  assigned 
to  these  imaginary  surgical  conditions. 

Now,  if  a  neurasthenic  really  needs  a  surgical  operation,  the 
surgeon  should  not  hesitate  to  perform  it,  after  making  every 
effort  to  get  the  patient  in  the  best  possible  physical  condition 
for  the  ordeal.     But  I  want  emphatically  to  protest  against  this 


II 


TREATMENT  OF  NEURASTHENIA  407 

tendency  in  some  quarters  to  operate  upon  neurasthenics  and 
psychopathies.  The  results,  I  have  observed,  are  invariably 
disappointing  and  sometimes  the  patient  develops  a  veritable 
surgical  mania  or  operative  obsession. 

Just  the  day  before  this  writing  there  came  into  the  office 
a  woman  who  had  had  seven  operations,  five  majors.  The 
unfortunate  soul  looked  as  if  she  had  been  through  the  French 
and  Indian  war,  and  with  tearful  voice  she  insisted  that  I  con- 
sent to  the  performance  of  an  operation  to  stitch  up  a  floating 
right  kidney,  which  she  was  told  she  had  nine  years  ago;  and 
having  had  every  other  possible  operation  performed,  every 
movable  organ  fixed  and  every  fixed  organ  rendered  movable, 
and  all  with  no  improvement  at  all  in  her  nervous  condition, 
she  at  last  decided  that  all  her  miseries  were  due  to  this  floating 
kidney,  and  that  her  future  happiness  depended  upon  under- 
going another  major  operation  and  having  it  stitched  up.  And 
I  may  add  in  this  connection  that  her  kidney  was  no  more  a 
floating  kidney  than  that  which  may  be  found  in  the  case  of  half 
of  the  people  who  will  read  this  book,  and  she  would  never 
have  known  she  had  a  floating  kidney  if  she  had  not  been  care- 
lessly told  that  by  the  physician  nine  years  ago. 

I  think  it  was  Dr.  William  Mayo  I  once  heard  say  that  if 
nothing  could  be  done  to  stop  surgeons  from  operating  on 
neurasthenics,  there  should  be  some  legal  enactment  made  which 
would  at  least  provide  for,  say  three  or  four  months  in  the 
summer,  as  a  closed  season  for  neurasthenics  in  which  it  would 
be  against  the  law  to  operate  on  them,  and  thus  they  might  at 
least  be  afforded  the  same  protection  extended  to  numerous  birds 
and  other  wild  game. 

SUMMARY   OF   THE    CHAPTER 

1.  The  problem  of  treating  neurasthenia  is  not  merely  one  of 
physical  recovery  and  mental  training.  It  embraces  the  larger 
problem  of  teaching  the  patient  self-adjustment  to  modern 
society. 

2.  Some  nervous  patients  do  better  when  treated  away  from 
home.  Others  need  the  very  moral  training  that  is  developed 
by  getting  well  "  right  on  the  job." 

3.  The  headaches  of  neurasthenics  are  not  exclusively  nervous 


4o8  WORRY  AND  NERVOUSNESS 

in  their  origin.     There  is  usually  an  associated  element  of  auto- 
intoxication. 

4.  The  fatigue  products  of  the  nerve  cells  are  among  the 
deadliest  and  most  powerful  poisons  produced  in  the  human 
body. 

5.  Neurasthenic  headaches  are  treated  by  hot  foot  baths  and 
cold  compress  to  the  head.  Also  by  simultaneous  hot  and  cold 
to  the  head. 

6.  It  is  a  common  mistake  for  neurasthenics  to  over-bathe, 
especially  at  the  seaside.  When  not  overdone,  baths  are  of  the 
highest  value. 

7.  In  the  treatment  of  neurasthenia,  the  electric  light  bath  is 
preferable  to  Turkish  or  Russian  baths,  and  should  be  followed 
by  appropriate  terminal  procedures. 

8.  Following  tonic  baths,  electricity,  and  massage,  nervous 
patients  should  rest  quietly  for  an  hour  or  more. 

9.  Special  courses  of  baths  and  massage  can  be  adapted  to 
the  "low-pressure"  of  neurasthenics;  as  well  as  to  the  "high 
tension  "  of  the  pre-neurasthenic  state. 

10.  The  neutral  bath  (970  F.)  is  the  treatment  par  excellence 
for  insomnia. 

11.  Light  massage,  vibration,  and  manual  Swedish  movements 
are  invaluable  in  the  treatment  of  the  various  nervous  states. 

12.  Electricity  in  its  various  forms  is  a  valuable  remedial 
measure  and  does  most  good  to  those  patients  who  have  greatest 
faith  in  it. 

13.  Neurasthenics  do  best  when  engaged  in  some  light  and 
regular  employment  occupying  both  hands  and  mind. 

14.  Active  physical  outdoor  exercise  to  the  point  of  gentle 
perspiration  is  a  fine  treatment  for  neurotics. 

15.  "  Eurythmics "  is  a  new  system  designated  to  develop 
harmony  and  reciprocity  between  mind  and  muscle. 

16.  The  "  rest  cure  "  is  only  used  in  certain  cases  of  hysteria 
and  in  bed-fast  neurasthenics. 

17.  Neurasthenics  will  do  well  not  to  sleep  during  the  day. 
Then  on  retiring  with  a  care-free  mind  they  will  enjoy  sounder 
sleep. 

1 3.  Neurasthenics  should  keep  busy,  rest  sufficiently,  eat  heart- 
ily, and  in  the  winter,  keep  warm. 

'  19.  Nervous  patients  should  shun  dietetic  fads.  They  should 
have  an  abundance  of  food,  varied  in  character,  well  cooked, 
tastily  served,  and  well  masticated. 

20/  Don't  think  or  talk  dietetics  at  meal  time.  Keep  your  mind 
oft"  the  stomach  when  eating. 

21.  While  milk  and  eggs  are  good  foods  for  neurasthenics,  we 
do  not  approve  of  the  modern  indiscriminate  stuffing  fads. 


TREATMENT  OF  NEURASTHENIA 


409 


22.  Overeating  may  lead  to  autointoxication,  and  in  this  way 
greatly  add  to  the  patient's  disagreeable  symptoms  and  suffer- 
ings. 

23.  Neurasthenics  are  especially  in  danger  of  being  imposed 
upon  by  various  medical  and  surgical  fads  and  fancies. 

24.  In  times  past  many  neurasthenics  have  had  numerous  use- 
less or  unnecessary  surgical  operations  performed  upon  them. 


CHAPTER  XXXI 
STIMULANTS   AXD   NARCOTICS 

WHATEVER  may  be  our  views  as  to  the  wholesomeness 
of  the  habitual  or  moderate  use  of  stimulants  and  nar- 
cotics on  the  part  of  the  people  at  large,  there  can  be  little 
or  no  debate  attending  the  proposition  that  all  persons  of  nervous 
tendency  or  neurotic  taint  should  religiously  abstain  from  the 
use  of  alcohol  in  all  its  forms  as  well  as  to  eschew  all  other 
stimulating  or  narcotizing  drugs.  It  is  absolutely  necessary 
in  the  beginning  of  treatment  that  all  neurasthenics  should 
at  once  stop  the  use  of  stimulants.  Alcohol  and  tobacco  I 
advise  to  be  discontinued  at  once,  while  tea  and  coffee  may  be 
weakened  down  and  some  other  warm  drink  substituted  within 
a  month's  time. 

DAXGER  OF  SELF-DRUGGING 

It  has  been  my  observation  that  the  moral  resolution  and  the 
will  power  exercised  in  discontinuing  the  use  of  these  drugs 
has,  in  itself,  often  done  much  to  lay  the  foundation  for  the 
successful  treatment  and  final  cure  of  neurasthenia;  although, 
of  course,  the  patients  who  suddenly  discontinue  these  nar- 
cotics must  expect  to  feel  weakened  and  debilitated  and  good- 
for-nothing  for  a  week  or  ten  days,  and  it  is  during  this  time 
that  I  pay  particular  attention  to  giving  such  patients  a  thor- 
ough-going course  of  eliminating  and  tonic  baths. 

We  cannot  too  strongly  condemn  the  practice  of  self-drugging, 
which  so  many  neurasthenics  carry  on,  especially  the  taking  of 
coal  tar  products  for  headaches  and  sleeplessness.  I  refer  to 
such  common  remedies  as  the  bromides,  acetanilid,  antipyrin. 
phenacetin,  sulphonal,  and  trional.  These  remedies  can  never 
remove  the  cause  of  trouble,  and  they  are  highly  injurious  in 
that  they  weaken  the  heart  action  and  introduce  into  the  system 

410 


STIMULANTS  AND  XARCOTICS  411 

drug  poisons  which  irritate  the  nerves.  It  is  needless  to  caution 
the  reader  against  the  use  of  any  sort  of  "  dope  "  which  may 
contain  cocaine,  morphine,  or  heroin.  The  nervous  sufferer 
who  seeks  the  bliss  of  Nirvana  by  the  use  of  these  deadly  drugs 
is  doomed  to  certain  disappointment  in  that  they  will  ultimately 
wake  up  and  find  themselves  suffering  the  tortures  and  torments 
of  a  literal  hell,  mentally,  morally,  and  physically.  It  must  be 
remembered  that  when  worry  is  cast  out  by  drugs,  like  the 
demon  of  old  it  is  sure  to  return  ere  long,  with  seven  devils 
more  wicked  than  itself. 

THE   TOBACCO    HABIT 

Some  patients  are  able  to  give  up  their  tobacco  without  a 
struggle,  even  when  the  habit  is  of  years  standing,  while 
others  succeed  only  after  a  severe  fight  or  after  repeated 
attempts.  We  are  never  able  to  estimate  the  hold  which 
tobacco  has  upon  a  given  patient,  and  we  are  not,  therefore,  in 
position  to  estimate  the  effort  which  will  be  required  to  gain 
one's  freedom  from  this  drug  habit.  I  have  found  the  so-called 
silver  nitrate  treatment  of  the  cigarette  habit  valuable  —  it 
at  least  possesses  a  psychological  value  —  in  that  it  represents 
something  definite  being  done  for  the  "  cure  "  of  the  patient. 
Other  aids  in  breaking  up  the  nicotine  habit  are  the  use  of 
Turkish  or  Russian  baths,  the  wet  sheet  pack,  and  the  electric 
light  bath.  Electricity,  preferably  in  the  form  of  galvanism 
to  the  spine,  fomentations  to  the  spine,  leg  baths  with  cold  appli- 
cations to  the  head,  fomentations  or  arc  light  over  the  stomach 
and  liver,  warm  baths  and  cold  salt  rubs,  are  all  effective 
measures  in  relieving  the  nervousness  from  which  so  many 
patients  suffer  immediately  after  giving  up  tobacco.  Graduated 
cold  baths  may  also  be  given  daily  in  connection  with  these 
eliminative  procedures. 

In  applying  fomentations  use  a  piece  of  ordinary  woolen  bed 
blanket,  or  a  thick  woolen  cloth  of  any  sort:  in  the  absence 
of  other  materials  even  a  towel  will  serve.  This  fomentation 
cloth  should  be  wrung  as  dry  as  possible  out  of  water  as  hot  as 
the  patient  can  bear,  placed  across  the  stomach  and  covered 
with  a  larger  piece  of  dry  flannel  or  blanket  to  aid  in  retaining 


4i2  WORRY  AXD  XERVOUSXESS 

the  heat.  Retention  of  heat  is  further  aided  hy  putting  over  this 
second  piece  of  flannel  a  strip  of  mackintosh.  Burning  of  the 
surface  of  the  skin  may  be  avoided  by  placing  the  wrung-out 
flannel  upon  a  piece  of  dry  towel,  one  end  of  which  may  be 
folded  over  the  fomentation,  and  over  this  in  turn  the  dry 
flannel  and  mackintosh.  The  fomentation  should  be  renewed 
at  intervals  of  three  or  four  minutes  —  whenever  it  begins 
to  cool.  In  removing  the  fomentation  for  renewal,  care  should 
be  taken  that  the  dry  wrappings  are  quickly  replaced  upon  the 
skin  so  as  to  prevent  chilling  of  the  warmed  skin  surface.  At 
the  end  of  the  fomentations  which  may  last,  if  desired,  fifteen 
to  twenty  minutes,  the  heated  surface  of  the  skin  should  be 
vigorously  sponged  or  rubbed  with  cold  water  and  dried  quickly. 

The  moist  abdominal  girdle  which  is  worn  between  applica- 
tions and  at  night,  consists  of  a  linen  bandage,  eight  or  nine 
inches  wide  wound  about  the  body  after  being  wrung  out  of 
ice  cold  water,  over  this  a  water  proof  covering  of  oiled  silk, 
or  mackintosh,  or  other  impervious  material,  while  over  both 
of  these  is  placed  a  flannel  bandage  three  or  four  inches  wider. 
It  is  a  good  practice  to  wear  this  girdle  all  night  for 
several  weeks  or  even  months,  if  there  is  a  tendency  toward 
constipation. 

The  sweating  pack  is  also  valuable  and  consists  of  a  three  or 
four  minute  bath  at  a  temperature  of  1050  to  uo°  F.,  followed 
bv  wrapping  in  a  linen  sheet  wrung  out  of  cold  water,  while  the 
patient  is  further  protected  by  being  wrapped  in  a  double  blanket 
so  as  to  induce  immediate  and  profuse  sweating.  At  the  end 
of  the  pack,  the  patient  should  be  given  a  cold  sponge  or  cold 
mitten  friction  in  order  to  prevent  subsequent  chilling  of  the 
body  and  the  catching  of  cold.  Any  and  all  of  these  measures 
are  also  beneficial  in  treating  cases  of  alcoholism  and  ridding 
the  system  of  other  drugs. 

THE   ROLE   OF   ALCOHOL 

Alcohol  temporarily  lowers  the  blood-pressure.  Just  as  to- 
bacco produces  a  pale  skin  and  drives  the  blood  inside,  thus 
raising  the  pressure,  alcohol  produces  a  red  flush  of  the  skin, 
showing  that  the  blood  is  being  drawn  to  the  surface  and  the 


IMHBOT 


STIMULANTS  AXD  XARCOTICS  413 

blood-pressure  lowered.  This  is  why  one  feels  warm  under  the 
influence  of  alcohol,  even  when  he  is  colder,  or  even  freezing. 

Xow  we  begin  to  understand  the  vicious  circle  of  multiple 
drug  addictions.  A  large  part  of  the  people  use  tobacco. 
They  are  all  living  the  strenuous  life.  Their  dietetic  and  gen- 
eral living  habits  are  those  belonging  to  the  strenuous  order. 
They  use  large  quantities  of  condiments,  tea  and  coffee.  But 
this  cannot  be  kept  up  indefinitely  without  producing  results. 
Several  times  a  day,  a  week,  or  a  month,  the  neurotic  individual 
reaches  the  "  bursting  stage."  He  feels  wrought  up  to  the 
highest  pitch;  keyed  up  to  the  last  notch.  He  is  intensified  to 
the  highest  degree.    He  must  in  some  way  find  a  safety  valve. 

There  must  be  some  way  to  relieve  this  constantly  increasing 
tension,  and  the  patient  finds  temporary  relief  by  taking  alcohol, 
which  not  only  dilates  the  blood-vessels  of  the  skin,  thus 
relieving  the  blood-pressure,  but  also  benumbs  the  higher  sensi- 
bilities so  that  they  are  not  susceptible  to  the  fears,  worries, 
anxieties,  griefs,  and  disappointments  that  were  previously 
harassing  the  mind.  In  this  way.  alcohol  affords  a  welcome 
temporary  relief  to  the  distracted  nerves  of  the  restless  and 
neurotic  victims  of  the  high-pressure  life. 

Hand  in  hand  with  the  enormous  consumption  of  tea  and 
coffee,  there  is  found  the  steadily  increasing  use  of  the  various 
quieting  preparations  and  combinations  of  the  bromides.  Tea 
and  coffee  slightly  raise  the  blood-pressure  —  the  bromides  and 
their  compounds,  as  a  general  rule,  by  the  sedative  action,  lower 
the  blood-pressure:  and  so.  just  as  alcohol  and  tobacco  play  their 
neurotic  victims  into  each  other's  hands,  the  heavy  and  habitual 
users  of  tea  and  coffee  find  deceptive  relief  in  the  use  of  brom- 
ides and  other  quieting  headache  remedies  and  sleeping  powders. 

SUGAR   VERSUS   ALCOHOL 

I  have  long  been  interested  in  the  study  and  observation  of 
the  dietetic  habits  of  periodical  drinkers  and  chronic  inebriates, 
and  have  become  finally  convinced  that  heavy  drinkers  are  all 
suffering  from  a  more  or  less  disordered  metabolism.  I  have 
observed  that  they  are  usually  inordinately  fond  of  fiery  condi- 
ments and  various  highly  spiced  foods.     They  are  quite  often 


4i4  WORRY  AXD  XERVOUSXESS 

heavy  meat  eaters  and  I  have  found  large  numbers  of  drinkers 
who  eat  but  small  amounts  of  the  carbohydrates,  particularly 
of  sugar.  I  am  not  alone  in  observing  this  latter  condition. 
Dr.  Spitzig  and  others  have  recently  suggested  that  the  abnormal 
craving  for  alcohol  is  directly  associated  with  the  under-eating 
of  sugar  and  the  over-use  of  pungent  condiments  and  other 
highly  seasoned  foods.  It  should  be  noted  that  the  saloon  pro- 
vides condiments  and  not  candy  in  connection  with  the  "  free 
lunch."  It  is  a  settled  fact  in  my  experience  that  even  moderate 
users  of  alcohol  are  not  as  a  rule  very  fond  of  candy;  as  the 
supply  of  alcohol  is  increased  the  desire  for  sugars  seems  to  be 
correspondingly  decreased.  I  have  had  alcoholics  under  my 
care  who  had  a  positive  dislike  for  candy  or  sugar  in  any 
form.  As  a  rule  heavy  drinkers  do  not  use  sugar  in  their  tea 
or  coffee:  neither  are  they  very  fond  of  pastries  and  desserts. 
There  can  be  but  little  doubt  on  the  other  hand  that  the  inordi- 
nate appetite  for  stimulating  food,  highly  seasoned  meats  and 
other  articles  of  diet  rich  in  condiments,  tends  directly  to 
create  a  physical  demand  for  alcohol  —  a  thirst  which  water 
cannot  quench. 

The  chemical  relation  of  carbohydrates  to  alcohol  is  signifi- 
cant. Dextrose  is  convertible  into  carbon  dioxid  and  ethyl 
alcohol.  The  combination  of  carbon,  hydrogen,  and  oxygen 
makes  for  increased  nutrition  whether  it  be  derived  directly 
from  alcohol  or  indirectly  from  sugars  and  starches.  The 
human  organism  when  deprived  of  sufficient  sugar  seems  likely 
to  demand  an  increased  supply  of  alcohol.  Conversely,  when 
the  body  is  satiated  with  alcohol,  it  has  little  need  for  carbo- 
hydrates. 

While  the  sugar  treatment  of  alcoholics  is  far  from  being 
a  ••  cure,"  nevertheless  I  have  found  that  this  theory  works 
out  to  practical  advantage  in  the  managment  of  those  habitual 
or  moderate  drinkers  who  desire  entirely  to  discontinue  the  use 
of  alcohol.  I  advise  these  patients  to  eat  sugar  upon  their 
cereals,  to  eat  a  large  quantity  of  sweet  fruits,  pastries,  choco- 
lates (not  between  meals),  and  ice-cream,  and  in  order  to  avoid 
over-irritating  the  stomach  by  the  consumption  of  too  much 
cane  sugar.  I  advise  these  patients  to  use  some  of  the  manu- 


STIMULANTS  AXD  XARCOTICS  415 

factured  malt  preparations  which  are  on  the  market;  and  in 
some  cases  where  a  psychological  effect  of  the  "  sugar  diet " 
is  highly  desirable,  I  have  followed  the  advice  to  give  a  dram 
of  lactose  in  powdered  form  every  two  hours.  The  employ- 
ment of  the  sugar  treatment  in  alcoholics  seems  to  be  attended 
with  good  results,  but  whether  it  is  due  to  any  chemical  action, 
as  is  claimed  for  the  silver  nitrate  treatment  of  the  cigarette 
habit,  or  whether  the  beneficial  effects  in  both  instances  are 
largely  psychic,  I  am  not  at  this  writing  prepared  to  say.  I 
can  only  record  my  observation  of  the  fact  that  both  procedures 
seem  to  be  of  practical  assistance  in  the  management  of  these 
cases  and  I  have  seen  no  harmful  effects  attend  the  use  of 
either. 

MODERATE    DRINKING 

I  am  fully  aware  of  the  fact  that  when  I  counsel  a  neuras- 
thenic to  give  up  the  use  of  alcohol,  I  am  in  a  measure  imposing 
a  form  of  social  isolation  upon  him.  I  am  further  conscious 
of  the  fact  that  I  am  asking  him  to  undergo  a  peculiar  species 
of  fraternal  self-denial  and  sociologic  hardship.  But  are  not 
these  the  very  sterling  and  manly  qualities  which  the  neuras- 
thenic stands  in  such  great  need  of?  Are  not  will-power  and 
self-control  the  very  virtues  he  must  cultivate  in  order  to  bring 
about  his  cure?  Besides,  are  not  our  neurotic  patients  the 
very  ones  who  stand  in  greatest  danger  of  allowing  their 
social  tippling  and  moderate  drinking  to  lead  them  ultimately 
and  hopelessly  into  the  toils  of  chronic  inebriety  and  confirmed 
dipsomania?  Are  not  these  patients  the  very  ones  who  start 
out  in  great  self-confidence  to  drink  moderately  and  end  up 
hopeless  victims  to  the  alcohol  habit? 

It  is  these  neurasthenics,  these  disordered  and  inefficiently 
controlled  beings  who  stand  in  greatest  danger  of  becoming 
habitually  addicted  to  any  and  all  of  the  commonly  used  drugs 
including  alcohol,  and  they  represent  a  type  of  human  being 
which  it  is  most  difficult  to  deliver  from  the  habit  when  once 
it  is  formed.  In  this  connection  I  can  do  no  better  than  to 
quote  a  portion  of  a  letter  from  a  confirmed  alcoholic  published 
in  a  recent  work  on  nerves. 


4l6 


WORRY  AXD  XERVOUSXESS 


THE    WOES    OF    INEBRIETY 


I  realize  how  necessary  it  is  that  I  should  abstain  from  alcohol,  and 
countless  times  I  have  resolved  to  do  so.  I  have  fortified  my  resolu- 
tion with  prayer,  by  appeals  to  that  Source  from  which  we  are 
promised  that  there  shall  be  no  denial  if  we  go  sincerely  and  humbly. 
How  often  have  I  read,  "  Whatsoever  ye  shall  ask  in  prayer,  believ- 
ing, ye  shall  receive,"  and  how  bitterly  disappointed  I  have  been  that 
my  appeals  are  always  unheeded!  I  have  strengthened  my  will  by 
pledges  to  one  whom  I  hold  in  higher  regard  than  any  one  in  the 
world;  by  physical  discipline,  and  by  counsel  from  your  profession. 
I  have  sought  refuge  in  the  country,  remote  from  centers  where 
drink  was  to  be  obtained.  I  have  availed  myself  of  the  sanity,  the 
loyalty,  and  the  devotion  of  my  wife  by  sharing  with  her  my  fears 
and  my  determination  to  make  a  daily,  an  hourly  fight  against 
temptation.  I  have  even  taken  the  Keeley  Cure !  Yet  all  to  no  avail. 
My  physician  says  I  am  threatened  with  neuritis  and  acute  Bright's 
disease,  and  tells  me  that  I  must  stop  alcohol.  He  neglects  to  tell  me 
how  I  shall  stop.  I  have  no  desire  to  disgrace  my  family  or  to  fill 
with  misery  and  incapacity  the  years  that  remain  to  me.  I  am  a 
man  of  sentiment  and  of  education,  possessed  of  a  sense  of  duty  to 
my  family,  and  to  the  community  in  which  I  live  —  and,  delivered 
from  this  demon,  it  is  possible  that  I  might  be  able  to  do  something 
that  would  contribute  to  the  joy  of  living  for  others.  But  unless  I 
can  get  aid  I  am  done  for,  and  the  sooner  I  experience  translation 
the  better  for  me  and  for  all  those  whom  my  existence  concerns. 

It  is  not  alone  the  fact  that  my  capacity  for  work  has  gone,  but  I 
am  enthralled,  enslaved,  emasculated.  There  was  a  time  when  I 
awoke  each  morning  with  a  joy  of  life,  a  desire  to  accomplish,  a 
capacity  to  do,  a  feeling  of  well  being,  which,  now  that  they  are  only 
memories,  are  to  me  as  the  sight  of  green  meadows,  winding  rivers, 
and  cool  forests  to  the  traveler,  irretrievably  lost  in  the  desert. 
Occasionally  I  used  to  be  able  to  go  two  or  three  days  without  re- 
course to  drink,  and  then,  despite  my  strongest  effort,  I  would  blot 
out  every  mental  and  moral  resemblance  to  my  Maker.  Gradually 
there  fell  from  me,  like  rags  from  a  beggar,  the  desire  or  the  willing- 
ness to  abstain  at  all,  and  in  its  place  came  my  present  incessant 
craving.  I  see  the  necessity  for  work.  I  see  it  lie  before  me  in 
various  stages  of  incompletion ;  I  realize  the  weighty  obligations 
that  are  imposed  upon  me  by  my  children.  I  am  deeply  conscious  of 
the  finger  of  contempt  pointed  at  me  by  my  fellow-men;  I  have  a 
sincere  desire  to  live  a  life  of  usefulness  and  to  accomplish  some- 


STIMULANTS  AND  NARCOTICS  417 

thing  worth  while.  No  one  can  realize  more  keenly  than  I  do  that 
I  must  deliver  myself  from  this  octopus  which  has  fastened  itself 
upon  me,  which  has  sapped  my  moral  fiber  and  destroyed  my  will- 
power. It  availeth  nothing  to  tell  me  that  I  must  stop;  as  well  tell 
water  not  to  run  down  hill  or  sap  not  to  well  upward  in  the  tree. 
Nor  are  any  of  the  devices  or  admonitions  which  have  been  sug- 
gested to  me  adequate  to  combat  it. 

It  will  not  suffice  to  give  me  advice  and  a  prescription.  That  has 
all  been  done  before  and  it  has  availed  nothing.  What  I  ask  is  a 
resuscitation  from  a  state  of  death  as  real  as  that  from  which  Laza- 
rus rose.  That  required  a  miracle,  and  I  am  convinced  that  nothing 
less  will  suffice  for  me. 

ADVICE   TO    DRINKERS 

As  illustrative  of  my  own  methods  of  reasoning  with  the 
unfortunate  victims  of  drink,  I  can  do  no  better  than  to  quote 
Dubois : 

A  young  man  came  to  me  because  he  gave  way  to  drink ;  he  volun- 
tarily sought  the  consultation  in  the  desire  of  being  cured.  With  the 
plenary  indulgence  that  we  owe  to  these  strayed  ones,  I  point  out  to 
him  the  various  reasons  why  he  should  give  up  his  habit;  such  as 
consideration  for  his  physical  health,  his  material  and  moral  future 
and  the  remorse  that  makes  him  unhappy.  I  urge  him  to  take 
courage  again  and  kindle  his  desire  for  a  worthier  life  that  will  re- 
store happiness  to  his  family.  He  listens  and  answers  sadly:  "  What 
can  you  expect?  It  is  stronger  than  I."  "  My  dear  sir,"  I  say,  "  It  is 
needless  to  tell  me  that;  you  speak  of  the  past,  and  it  is  in  fact  past; 
we  cannot  alter  it  in  any  way.  Your  passions  have  been  stronger 
than  the  motives  of  reason.  Let  us  speak  no  more  of  the  past."  — 
"  It  is  the  future  of  which  I  am  talking,"  he  replies,  "  I  have  so  often 
tried  to  correct  myself  without  succeeding,  notwithstanding  that  I 
already  quite  recognize  the  value  of  the  moral  reasons  you  set  be- 
fore me." 

Yes,  I  see  that  you  judge  of  the  future  from  the  past,  as  when  we 
say  "  He  who  has  drunk  will  drink."  Do  you  not  know  that  the 
temperance  and  abstinence  societies  have  frequently  given  the  lie  to 
that  discouraging  proverb?  Besides,  in  the  name  of  logic,  I  cannot 
allow  you  to  speak  of  the  future.  We  have  always  the  right  to  say  "  It 
has  been  stronger  than  I";  but  one  cannot  say  "It  will  be  stronger 
than  I."  Doubtless  the  past  may  make  you  fear  for  the  future,  but 
do  not  forget  that  the  latter  does  not  belong  to  us.     Between  now 


4i8  WORRY  AXD  NERVOUSNESS 

and  tomorrow,  or  later,  events  may  happen  in  your  material,  intel- 
lectual, or  moral  life  that  will  determine  other  conduct  for  you. 
Suppose  even  that  you  relapse  this  evening,  tomorrow,  the  day  after 
or  many  times  again.  Every  time  that  you  come  to  confide  your  fault 
to  me  I  shall  have  the  same  plenary  indulgence  for  a  past  that  no 
one  can  change.  Each  relapse  belongs  to  the  past  periods  of  life; 
of  the  future  neither  you  nor  I  know  anything  yet.  The  faults  of 
our  life  are  like  railway  accidents;  a  train  is  derailed;  that  belongs 
to  the  past,  and  it  is  no  reason  that  the  next  one  should  also  run  off 
the  rails.  Is  it  not  probable  that  the  pointsman  found  to  be  at  fault 
will  give  more  careful  attention  to  his  duty  in  the  future? 

Reflect  and  realize  more  and  more  clearly  that  your  conduct  is 
leading  you  into  a  quagmire;  the  more  you  see  the  danger  the  more 
you  will  recoil  from  it  appalled.  There  has  never  been  but  one  way 
to  correct  a  vice,  namely,  to  recognize  the  dangers  it  entails  for  us ; 
there  is  but  one  way  of  acquiring  a  virtue;  that  is  to  see  clearly  the 
advantages  it  brings  us.  Beyond  that  there  is  no  wisdom.  Continue, 
not  to  make  vain  efforts  of  will,  like  a  man  uselessly  waving  his 
arms,  but  to  acquire  by  reflection,  by  my  counsels  which  are  drawn 
from  experience,  the  moral  clear-sightedness  which  safeguards  our 
always  difficult  journey  along  the  path  of  life.  The  progress  of  a 
man  in  the  moral  world  is  like  that  of  an  explorer  in  an  unknown 
country.  He  often  loses  his  way,  and  his  only  guides  are  his  natural 
instincts,  his  own  experience  and  that  of  the  travelers  who  have 
preceded  him.  When  he  discovers  that  he  is  astray  he  should  re- 
trace his  steps  and  seek  the  right  road.  What  would  you  say  of  the 
man,  who.  instead  of  making  inquiries,  lay  down  at  the  side  of  the 
road  and  wept  over  his  past  mistakes?  —  Go  now  and  come  back  and 
see  me  in  a  few  days.  You  will  always  receive  the  same  kindness, 
the  same  patience,  but  also,  understand,  the  same  arguments,  be- 
cause there  are  no  others. 

PHYSICAL   AXD   MORAL  TREATMENT 

In  the  physical  treatment  of  alcoholism  we  follow  the  same 
general  lines  as  those  suggested  in  connection  with  the  tobacco 
habit,  the  purpose  being  to  facilitate  the  elimination  of  the 
drug  while  the  nervous  system  is  toned  up  by  means  of  hydro- 
therapy, electricity,  and  massage.  In  this  way  it  is  possible 
greatly  to  shorten  the  period  of  time  in  which  the  patient 
experiences  those  undesirable  reaction  effects  which  follow  the 
sudden  discontinuance  of  the  regular  use  of  any  drug. 


STIMULANTS  AND  NARCOTICS  419 

The  moral  treatment  of  the  neurotic  alcoholic  consists  in  first 
having  him  sign  a  pledge  solemnly  promising  to  give  up  the 
use  of  alcohol.  I  prefer  to  have  these  patients  sign  a  religious 
pledge;  in  fact,  it  has  been  my  observation  —  and  I  have  studied 
a  great  number  of  these  cases  —  that  the  "religious  cure''  of 
inebriety,  while  far  from  being  infallible  and  all-powerful,  is 
nevertheless,  able  to  exhibit  a  larger  number  of  patients  per- 
manently cured  than  any  other  regime  with  which  I  am  ac- 
quainted. The  Rescue  Missions  of  our  large  cities  are  able  to 
exhibit  a  vast  and  interesting  gallery  of  temperance  heroes  who 
have  been  raised  up  from  the  drunkard's  gutter  and  who,  by 
the  combined  religious  and  psychic  forces  kept  at  work  in 
connection  with  their  religious  association,  meetings,  etc.,  are 
kept  sober  year  after  year.  As  I  have  pointed  out  elsewhere, 
these  moral  associations  and  spiritual  influences  are  all  highly 
useful  in  uplifting  the  victims  of  drink. 

MORPHINE 

Morphine  lowers  the  blood-pressure;  so,  when  the  individual 
has  used  tobacco  or  cocaine,  which  result  in  unduly  raising 
the  pressure,  it  is  only  natural  that  he  should  seek  relief  from 
this  tension  by  the  use  of  either  alcohol  or  morphine.  This 
is  why  alcohol  and  tobacco  go  hand  in  hand,  tobacco  producing 
high-pressure;  but  a  low-pressure  cannot  be  long  tolerated  — 
the  individual  must  have  something  to  tone  him  up,  to  restore 
the  pressure,  and  this  is  secured  by  more  tobacco.  Likewise, 
morphine  and  cocaine  play  into  each  other's  hands  —  the  one 
temporarily  counteracting  the  effects  of  the  other,  until  the  un- 
fortunate victim  is  a  user  of  both.  All  methods  of  relieving 
high  tension  or  overcoming  insomnia  by  drugs  are  snares  and 
delusions. 

I  have  observed  that  a  great  many  victims  of  some  drug  habit 
especially  in  the  case  of  morphine  and  its  cousins,  have  begun 
the  use  of  the  drug  as  a  means  of  relieving  pain  or  some 
other  physical  distressing  sensation.  I  think  it  will  be  helpful, 
therefore,  in  this  connection,  to  call  attention  to  the  numerous 
ways  in  which  pain  can  be  relieved  without  resort  to  the  use 
of  pain-killers  and  other  drugs  and  opiates. 


420  WORRY  AND  NERVOUSNESS 

TWENTY-FIVE    WAYS   OF   TREATING    PAIN    WITHOUT    DRUGS 

An  entire  chapter  could  profitably  be  devoted  to  the  subject 
of  relieving  pain  without  drugs,  but  we  can  here  give  but  the 
briefest  outline  of  the  different  physical  measures  which  are 
serviceable  in  the  treatment  of  pain. 

i.  Hot  water  bag.  Hot  water  rubber  bags  of  various  shapes 
and  sizes  are  invaluable  in  the  treatment  of  mild  pains  in  the 
back  and  abdomen,  not  to  mention  neuralgias. 

2.  Hot  fomentations.  The  fomentations  are  excellent  pain 
killers.  They  can  be  given  in  a  series  or  followed  by  a  cold 
rub  or  a  cool  compress.  In  other  cases  they  may  be  followed 
by  the  all-night  heating  compress  previously  described. 

3.  Hot  sponging.  The  water  should  be  used  as  hot  as  the  pa- 
tient can  bear;  in  fact,  it  should  be  almost  painful,  and  is 
especially  valuable  in  neuralgia  and  backache. 

4.  Alternate  sponging.  This  method  is  valuable  in  the  pain 
of  internal  congestion  and  should  be  made  over  the  painful 
part.     Alternate  compresses  are  also  useful. 

5.  The  heating  compress.  This  is  applied  by  wringing  the 
cloth  out  of  cold  water,  putting  over  the  painful  part,  covering 
with  mackintosh  and  several  thicknesses  of  flannel,  as  previously 
described.     It  acts  like  a  poultice.     This  is  excellent  in  neuritis. 

6.  Alternate  hot  and  cold.  Many  cases  of  pain  which  do  not 
yield  to  heat  are  relieved  by  the  alternate  use  of  the  hot-bag 
and  the  ice-bag,  or  the  alternation  of  fomentations  and  the 
ice-bag. 

7.  The  ice-bag.  Cold  will  sometimes  relieve  the  pain  of 
deep-seated  inflammation  better  than  heat,  as  in  the  case  of  the 
ice-bag  in  acute  appendicitis.  Cold  rubbing  is  also  sometimes 
helpful,  as  well  as  cold  compresses,  in  headache. 

8.  Electricity.  Both  galvanic  and  high-frequency  electricity 
are  used  very  effectively  in  the  treatment  of  different  pains. 

9.  Diathermy.  This  is  probably  the  latest  scientific  treatment 
of  pain  and  consists  in  the  conversion  of  electric  currents  into 
heat  after  they  have  penetrated  the  tissues. 

10.  Hot  air.  Hot  air  is  a  great  pain  reliever  as  used  in 
"  oven  baking  "  for  rheumatism,  or  in  heated  air  currents  for 
ear  troubles. 


STIMULANTS  AXD  NARCOTICS  421 

11.  Live  steam.  A  jet  of  live  steam  directed  upon  the  sciatic 
nerve  is  the  best  known  treatment  for  relieving  that  painful 
condition. 

12.  The  arc  light.  The  therapeutic  arc  light  is  highly  useful 
in  treating  neuritis  and  deep-seated  pains  in  abdomen  and 
other  parts  of  the  body. 

13.  Sunlight.  Sunshine  is  good  for  pain.  Animals  when 
suffering  pain  always  lie  down  in  the  sun.  The  heat  of  an 
open  flame  or  an  open  fire  place  may  also  be  thus  utilized. 

14.  Radiant  heat.  This  is  applied  by  means  of  an  incandescent 
electric  lamp  placed  in  some  sort  of  a  reflector,  and  is  excellent 
in  neuritis,  neuralgia,  and  other  acute  pains. 

15.  Poultices.  Poultices  when  applied  by  means  of  cotton, 
corn  meal,  flaxseed  or  potter's  clay  (antiphlogistine)  are  all 
highly  useful  in  treating  and  relieving  pain. 

16.  General  hot  batJi.  Severe  internal  pain  as  in  gall  stones 
and  even  in  sciatica  is  sometimes  best  relieved  by  a  very  hot  full 
bath. 

17.  Hot  blanket  pack.  Like  the  hot  bath,  the  packs  are  very 
useful  in  generalized  pain,  rheumatism,  and  other  achy  sen- 
sations. 

18.  Hot  foot  bath.  It  should  be  taken  as  hot  as  can  be  borne. 
The  leg  bath  is  still  more  effective.  These  baths  are  especially 
useful  in  relieving  nervous  headaches  and  deep-seated  pain  in 
the  pelvis. 

19.  Hip  and  leg  pack.  Hot  packs  to  the  hips  and  legs  are 
especially  valuable  in  deep-seated  pain  of  the  abdomen  and 
pelvis.  In  painful  menstruation  an  ice-bag  may  be  slipped  in 
under  the  pack  and  applied  to  the  seat  of  pain. 

20.  Hot  sitz  bath.  These  baths  should  be  started  at  a  tem- 
perature of  1020,  and  gradually  raised  to  no  or  1150  —  as  hot 
as  can  be  borne.  The  feet  should  be  in  water  as  hot  as  can  be 
borne. 

21.  The  hot  enema.  Temperature  of  the  water  may  be  from 
102  to  1070,  and  is  an  invaluable  treatment  for  intestinal  pain, 
as  well  as  the  pain  of  gall  stones,  rheumatism,  pelvic  pains, 
inflammation  of  the  bladder,  neuralgia,  etc. 

22.  Rest.    Many  forms  of  pain  will  be  greatly  relieved  if  the 


422  WORRY  AXD  XERVOUSXESS 

painful  member,  or  the  entire  body,  is  put  at  absolute  rest  in  bed. 

23.  Position.  Pain  in  the  limbs  is  often  greatly  relieved  by 
elevating  the  feet,  or  by  raising  the  foot  of  the  bed  upon  which 
the  patient  lies. 

24.  Diverting  tJie  attention.  Patients  are  often  relieved  of 
mild  pain  by  reading  a  fascinating  book,  or  by  the  conversation 
of  congenial  friends. 

2$.  Mental  training.  Many  patients  are  able  to  train  them- 
selves to  bear  a  certain  amount  of  suffering.  In  this  way  they 
avoid  the  use  of  drugs  while  time  and  nature  bring  about  a 
cure.  And  so  we  would  earnestly  urge  the  reader  to  try  one 
or  more,  or  even  a  number  of  these  methods  for  relieving  acute 
or  chronic  pain,  before  resorting  to  the  continuous  use  of  any 
of  the  habit  forming  drugs. 

SUMMARY   OF   THE    CHAPTER 

1.  Whatever  the  arguments  in  favor  of  moderate  drinking,  it 
goes  without  debate  that  neurotics  should  abstain  from  alcohol 
and  all  other  stimulating  and  narcotizing  drugs. 

2.  The  moral  resolution  and  will-power  exercised  in  giving  up 
drink  or  drugs  often  constitutes  the  beginning  of  the  M  cure  ''  of 
neurasthenia. 

3.  Those  neurotics  who  seek  Nirvana  by  the  drug  route  in- 
variably find  instead  a  literal  hell,  mentally,  morally,  and  phys- 
ically. 

4.  It  is  advisable  for  nervous  patients  to  discontinue  the  use 
of  tobacco  in  all  its  forms. 

5.  Hydrotherapy  administered  in  conjunction  with  psycho- 
therapy are  great  aids  in  overcoming  the  nicotine  habit. 

6.  Electric"  light  baths,  the  silver  nitrate  treatment,  and  other 
"  cures  "  are  all  helps  in  overcoming  the  cigarette  habit.  _ 

7.  Alcohol  and  morphine  lower  the  blood-pressure,  while  to- 
bacco and  cocaine  raise  blood-pressure,  and  thus  they  play  their 
victims  into  the  hands  of  each  other. 

8.  The  "  sugar  cure  "  for  alcoholism  is  based  on  sound  chem- 
ical reasoning  and  is  undoubtedly  of  some  value. 

9.  Neurotics  and  alcoholics  should  eschew  fiery  condiments  — 
avoid  those  things  which  create  a  thirst  which  water  cannot 
quench. 

10.  Neurasthenics  need  just  the  self-discipline  and  will-power 
which  is  required  in  the  social  and  public  abstinence  from  liquor. 

11.  The  individual  of  neurotic  constitution  is  the  very  one  who 


STIMULANTS  AND  NARCOTICS  423 

should  carefully  avoid  all  practices  which  are  likely  to  result  in 
drug  addictions. 

12.  It  is  the  neurotic  man  or  woman  who  starts  out  as  a  mod- 
erate or  social  drinker  and  ends  up  a  dipsomaniac. 

13.  The  cure  of  inebriety  lies  along  the  lines  of  hygiene,  per- 
sistent psychotherapy,  wholesome  environment,  together  with 
strong  moral  and  religious  influences. 

14.  The  neurasthenic  inebriate  must  look  forward,  not  back- 
ward; hope  for  such  dwells  only  in  the  future. 

15.  The  physical  treatment  of  alcoholism  by  baths,  etc.,  is 
along  much  the  same  line  as  that  advised  for  tobacco  users. 

16.  Neurasthenics  should  pay  particular  attention  to  avoid  the 
habitual  use  of  all  pain-relieving  and  sleep-producing  drugs. 

17.  There  are  twenty-five  different  non-drug  methods  of  re- 
lieving pain  and  these  should  be  fully  understood  and  intelligent- 
ly utilized  by  nervous  sufferers. 


CHAPTER  XXXII 

THE  WRITING  OR  ELIMINATION  CURE 

IN  A  former  chapter  we  laid  considerable  stress  upon  the 
desirability  of  eliminating  our  emotional  experiences  rather 
than  to  allow  them  to  accumulate  as  a  result  of  constant  suppres- 
sion. The  practical  outworking  of  this  teaching  necessitates 
that  some  provision  be  made  for  the  expression  of  the  patient's 
thoughts  and  feelings,  and  I  have  discovered  but  three  ways  in 
which  this  can  acceptably  be  accomplished.  The  nervous  patient 
is  able  to  gain  the  relief  of  emotional  expression  through  either 
talking,  as  in  medical  consultations;  in  writing,  as  in  the  keeping 
of  a  therapeutic  diary  for  the  physician;  and  in  praying  —  the 
personal  devotions  of  the  emotional  and  sincere  Christian 
believer. 

THE    WRITING    CURE 

While  our  patients  get  great  good  from  telling  their  story 
fully  and  freely  to  the  physician,  I  have  found  it  highly  unde- 
sirable to  allow  them  to  dwell  too  freely  or  frequently  upon 
their  melancholy  thoughts  and  morbid  feelings.  I  have  there- 
fore found  it  an  excellent  plan  to  have  these  patients  keep  a 
therapeutic  diary  —  a  diary  intended  only  for  my  personal  and 
confidential  inspection,  therefore  one  in  which  they  could  most 
freely  and  fearlessly  write  out  their  inmost  thoughts  and  feel- 
ings —  fully  indulge  in  the  expression  of  their  every  abnormal 
fear  and  emotional  whim. 

The  patient  brings  this  diary  to  my  office  once  a  week  or 
once  in  two  weeks  and  leaves  it  without  comment.  (I  instruct 
them  to  employ  two  books,  in  which  they  write  alternately 
between  visits  to  the  office.)  This  I  read  over  and  make  nota- 
tions of  those  things  I  desire  to  take  up  in  the  next  consultation 
and  in  this  way  I  have   found  that  the  hour  of  consultation, 

424 


m 


WRITING  OR  ELIMINATION  CURE  425 

instead  of  being  devoted  to  a  rehash  of  old  psychic  difficulties, 
is  more  profitably  occupied  by  a  therapeutic  visit  in  which  I 
can  in  an  intelligent  manner  direct  the  conference  into  those 
lines  which  will  meet  the  patient's  situation  as  shown  in  the 
diary  of  the  previous  week.  I  have  further  found  that  the 
"  diary  cure  "  is  an  excellent  means  of  getting  the  patients  to 
pin  themselves  down  to  definite  statements  and  to  train  them 
into  those  habits  of  precision,  system  and  order  which  are  such 
an  important  part  of  the  treatment  and  cure  of  neurasthenics 
and  psychasthenics. 

And  in  this  connection  I  think  I  can  do  nothing  better  to  help 
my  readers  to  help  themselves  along  these  lines  than  to  present 
in  this  chapter  numerous  selections  which  I  have  taken  from 
the  recent  diaries  of  my  neurasthenic  pupils  and  psychasthenic 
friends. 

TAKING   STOCK   IN   WORRY   AND   OBSESSIONS 

As  an  illustration  of  how  thoroughly  the  nervous  patients 
may  be  taught  to  understand  themselves,  to  discount  their  fears, 
to  classify  and  control  their  feelings  and  successfully  eliminate 
their  emotions,  I  offer  the  following  statement  just  handed  me 
by  a  patient  who  has  been  under  a  few  months'  treatment  and 
who,  before  she  was  discharged,  was  asked  to  submit  a  brief 
summary  of  the  causes  of  her  mental  difficulties  and  also  to 
make  a  statement  as  to  her  concept  of  the  means  which  had 
been  employed  to  effect  her  cure  and  which  she  must  continue 
to  use  in  order  to  maintain  a  healthy  and  normal  mental  state. 
It  is  needless  to  say  that  after  reading  over  the  following  con- 
cise, intelligent,  and  I  may  even  say,  scientific,  statement,  I  was 
prepared  to  dismiss  her  case  with  this  parting  admonition :  "  You 
understand  yourself  every  bit  as  well  as  I  do.  Your  statement 
is  evidence  that  you  know  exactly  how  your  cure  has  been 
brought  about,  and  I  may  therefore  safely  send  you  back  into 
the  big  wide  world  to  .take  your  place  as  one  of  its  workers, 
knowing  full  well  that  if  any  of  your  former  mental  'bugaboos  ' 
should  by  chance  find  their  way  back  into  your  experience,  you 
will  know  how  successfully  to  combat  these  psychologic  '  hob- 
goblins,' and  I  have  every  confidence  that  you  will  achieve  a 


426  WORRY  AXD  NERVOUSNESS 

complete  victory  over  them,  without  even  the  necessity  of  again 
consulting  me  for  help  in  these  matters.  I  congratulate  you  on 
the  splendid  and  brilliant  fight  you  have  made.  Your  statement 
shows  you  have  been  a  diligent  pupil,  a  studious  patient.  I  have 
every  confidence  in  you  and  I  believe  that  you  have  become  an 
intelligent  master  of  your  emotions.  Good-by ;  may  God  speed 
you  on  in  your  new  life  of  self-mastery."  I  now  quote  exactly 
as  was  handed  to  me,  the  patient's  final  statement,  which  we 
can  most  appropriately  call  her  Therapeutic  Graduating  Thesis. 

A    GRADUATING    THESIS 

In  compliance  with  your  request,  I  submit  the  following  statement 
of  the  causes  of  my  trouble,  and  also  the  cure,  as  I  understand  the 
matter : 

I.      THE   CAUSES 

i.  The  feeling  of  inability  to  take  charge  of  my  house  and  fam- 
ily—  and  aversion  to  it,  and  the  presence  in  the  house  of  an  uncon- 
genial relative. 

2.  Reading  Dr.  Evans'  article  in  the  Tribune,  in  which  he  said  — 
speaking  of  the  change  of  life:  "then  come  the  maniac  depressives, 
and  melancholies";  also  that  those  having  the  change  artificially 
brought  about  would  suffer  the  same  things  as  other  women,  I  had 
understood  that  such  was  not  the  case. 

3.  Since  my  earliest  childhood  I  have  felt  that  I  was  in  some  way 
different  from  other  people.  I  know  that  I  have  a  quick  and  bright 
mind,  but  that  I  am  not  a  deep  thinker.  Reading  articles  on  phrenol- 
ogy, etc.  I  realized  that  my  chin  was  weak,  and  my  head  too  flat  in 
the  back.  In  a  word,  I  feel  that  I  am  what  might  be  called  sub- 
normal. In  spite  of  this  I  have  led  a  happy,  useful  life,  and  have 
always  tried  to  think  that  I  was  only  responsible  for  my  life  and 
works ;  not  for  what  I  have  inherited. 

4.  Ordinarily  the  feeling  of  self-condemnation  and  all  the  evils 
which  come  with  introspection,  do  not  touch  me ;  but  during  the  last 
siege  of  nervousness  after  my  last  child  was  born,  these  thoughts 
and  worse  ones  fairly  seared  my  brain,  and  all  these  things  were 
revived  recently.  One  other  time  somebody  wrote  to  Dr.  Evans  in 
the  Tribune  saying  that  for  five  months  after  an  operation  on  her 
ovaries,  she  had  felt  fine;  then,  when  writing,  said  she  was  sick  all 
the  time.  Dr.  E.  replied  that  she  was  passing  through  the  change,  so 
even  now  the  thought  haunts  me  that  after  awhile  I  will  be  worse 
again. 


WRITIXG  OR  ELIMINATION  CURE  427 

5.  My  husband's  health,  and  his  consequent  nervous  state.  My 
worry  lest  he  too  will  break  down. 

6.  A  physical  cause  was  the  inflamed  condition  of  the  uterus, 
probably  caused  by  too  much  walking.  I  felt  I  must  get  out  of  the 
house,  and  probably  walked  too  much. 

7.  Reading  in  your  Faith  and  Fear  that  reeducation  of  the  will 
was  inadequate  to  cure  persistent  obsessions. 

8.  The  insurmountable  obstacle  and  burden  one  must  always  strug- 
gle against  who  was  reared  an  only  child  and  taught  from  infancy  to 
marriageable  age  to  depend,  not  on  herself,  but  on  others  for  every- 
thing. 

Right  here  I  will  be  self-assertive  and  state  that  considering  this, 
I  have  made  a  great  success.  All  the  self-reliance,  self-possession, 
self-control  I  now  have  I  have  gained  since  my  marriage. 

II.      THE    CURE 

1.  The  possession  and  assertion  of  naturally  good  instincts. 

2.  Praying  several  times  a  day. 

3.  The  presence  of  my  mother  and  father;  which,  besides  com- 
forting me,  relieved  me  of  a  part  of  housekeeping  cares. 

4.  The  conscious  statement  to  the  contrary  when  some  awful 
thought  came  into  my  mind. 

5.  Faith  in  you  and  in  my  ability  to  carry  out  your  instructions. 

6.  Improvement  in  uncongenial  surroundings. 

7.  The  proper  treatment  of  all  my  physical  ills  and  consequent  feel- 
ing of  returning  health,  and  the  hope  that  my  good  husband  will  be 
similarly  helped. 

8.  The  proper  understanding  and  recognition  of  the  role  of  "  mem- 
ory "  of  past  troubles  in  relation  to  present  and  future  difficulties. 

AUTO-PSYCH  ANALYSIS 

Xot  long  since  there  came  to  us  an  extremely  nervous  and 
highly  depressed  patient  to  whom,  after  the  first  or  second  con- 
ference, we  fully  explained  the  therapeutic  procedure  of  psych- 
analysis  and  advised  this  patient  to  undertake  the  careful  analy- 
sis and  introspection  of  her  psychological  life  and  emotional 
experiences ;  and  that  she  was  successful  in  her  undertaking  of 
auto-analysis,  I  think,  is  clearly  shown  by  the  following  extract 
from  her  written  report.  There  are  but  few  patients  who  can 
safely  be  trusted  with  this  delicate  and  dangerous  task.  I  may 
further  state  that  the  patient  made  rapid  and  continuous  prog- 


428  WORRY  AXD  NERVOUSNESS 

ress  from  that  day  to  this,  and  is  once  more  enrolled  among  the 
world's  workers,  enjoying  her  work  and  from  the  last  report, 
eminently  successful  in  it.  The  extract  from  her  auto-analytic 
report  runs  as  follows : 

I  think  I  did  not  know  depression  as  a  child.  About  the  time  I  was 
maturing,  we  spent  nearly  a  year  with  my  grandmother  in  the 
suburbs.  If  I  remember  correctly,  I  was  fifteen,  when  there  were 
five  accidental  deaths  caused  by  the  trains  at  a  grade  crossing.  I  saw 
some  of  the  bodies  under  sheets  and  a  morbid  horror  took  a  violent 
hold  on  my  mind,  so  that  I  shuddered  by  day  and  cried  out  in  my 
sleep  by  night.  I  was  normal  in  every  other  respect  and  enjoyed 
life,  but  death,  or  any  mention  of  it  filled  me  with  a  morbid  feeling. 
I  can  scarcely  describe  —  not,  in  any  sense,  a  fear  that  I  might  die, 
but  just  a  confused  horror.  Later  I  entered  high  school.  The  words 
moribus,  moribund,  in  fact,  any  word  derived  from  the  Latin  root 
meaning  death,  were  repellent  to  me.  A  black  cloth,  because  black 
signified  death,  was  unpleasant  to  my  sight. 

In  time,  this  particular  fear  w<>re  entirely  away  and  does  not,  in 
the  least,  affect  me  now.  Also  at  the  time  I  matured,  I  became  self- 
conscious  and  dreaded  to  recite  in  school  or  appear  before  the  pub- 
lic. Although  at  my  ease  in  general  conversation  and  among  people 
of  any  class,  I  still  retain  a  shrinking  fear  of  speaking  or  singing 
before  an  audience,  no  matter  how  small.  This,  of  course,  could  have 
been  overcome  by  a  little  sacrifice  of  pride. 

My  mother  was  a  deeply  religious  woman  and  because  of  so  much 
apparent  deadness  in  the  churches  sought  spiritual  uplift  and  inspira- 
tion from  teachers  outside  the  orthodox  folds. 

By  this,  I  mean  teachers  who  taught  holiness,  total  eradication  of 
sin  and  a  host  of  other  so-called  deeper  truths.  Most  of  these 
teachers  were  sane,  splendid  men  and  women,  but  I  was  at  the 
adolescent  period  and  put  a  morbid  construction  on  all  that  I  heard. 
I  had  no  brothers  or  sisters  and  I  worshipped  my  mother  with  a 
devotion  almost  unnatural,  at  least,  beyond  the  average.  We  were 
widely  different  in  our  natures  but  I  sought  to  believe  as  she  did. 
While  her  religion  brought  her  great  joy  and  peace,  mine,  in  spite 
of  all  I  could  do,  brought  me  misery.  As  I  have  said,  I  must  have  put 
a  wrong  construction  on  everything  that  was  said.  For  instance,  the 
doctrine  of  dying  to  self  was  utterly  unintelligible  to  me.  To  wear 
somber  clothes,  discard  all  that  the  girlish  heart  holds  dear,  in  short, 
to  live  the  life  of  4i  separation  n  meant  hell  to  me.  Intimately  related 
as  we  were  to  one  another,  I  did  not  tell  my  mother  of  the  fearful 


WRITING  OR  ELIMIXATIOX  CURE  429 

mental  agony  through  which  I  passed.  I  did  not  wear  plain  clothes 
and  lived  only  partially  a  "separated"  life,  but  I  worried  almost 
continuously.  When  not  under  this  teaching,  I  would  throw  the  bur- 
den off  for  a  time.  A  factor  that  made  the  struggle  doubly  hard 
was  that  I  had  inherited  the  pleasure-loving  nature  of  my  father.  I 
came  inwardly  to  shrink  in  terror  from  meetings  of  all  sorts  outside 
of  the  church.  For  more  than  twelve  years  I  have  been  troubled  by 
spiritual  things.  I  honestly  loved  the  church  but  shrank  from  so- 
called  deeper  teachings  —  too  many  to  mention.  It  seems  to  me, 
psychologically  speaking,  that  it  has  left  its  mark  on  me.     While 

talking  to  Mrs.  A of  these  things  one  day,  she  said  that  she  had 

never  known  anyone  to  have  a  similar  experience.  My  religious  ex- 
periences have  been  almost  too  paradoxical  to  explain  coherently. 
There  must  be  several  personalities  at  work  within  me,  for  one  cries 
out  for  free  liberality  of  thought,  though  not  without  the  confines  of 
orthodoxy.  For  instance,  to  this  personality  God  seems  a  splendid 
supreme  being  desiring  the  largest  liberty  for  his  children,  the 
richest  joy  and  prosperity.  To  the  other  personality,  held  by  fear, 
He  seems  an  absolute  tyrant,  wanting  only  that  every  talent  and 
thought  and  capability  pay  blind  and  unreasoning  tribute  to  Him  in 
craven  slavery. 

After  I  graduated  from  high  school,  I  passed  a  summer  of  despond- 
ency. Again,  after  an  exceptionally  hard  year  of  teaching,  I  expe- 
rienced another  melancholy  summer.  Soon  after  school  was  closed, 
I  went  to  a  lake  in  the  highest  spirits  and  not  depressed  in  the  slight- 
est degree.  Suddenly,  during  an  electrical  storm,  I  was  awakened  in 
the  night  by  the  most  fearful  depression.  It  seemed  active  and  alive, 
if  possible.  The  shock  lasted  all  summer.  It  expressed  itself  in  the 
feeling  of  imprisonment,  a  low  roof,  a  dark  room,  a  closed  carriage, 
even  the  darkness  filled  me  with  panic.  I  have  never  wholly  recov- 
ered from  that  feeling.  It  comes  to  me  in  the  spring  of  the  year. 
For  months  the  darkness  seemed  to  so  imprison  me  that  my  mother 
kept  a  light  burning  in  or  near  my  room  at  night.  This  developed 
within  me  a  terror  of  blindness.  Occasionally  during  a  time  of  de- 
pression, this  fear  possesses  me  for  a  time. 

Last  Thanksgiving  night  I  walked  alone  five  miles  in  the  moon- 
light, fighting  this  fear  of  blindness.  I  had  lost  my  mother  in  August 
and  was  under  great  depression.  There  was  absolutely  nothing 
wrong  with  my  eyes.  I  should  say,  here,  that  my  friends  have  not 
known  of  any  of  these  fears  and  I  am  considered  a  very  fearless 
person  ready  for  any  "  stunt."  I  have  never  feared  disease  until  the 
past  year  when  I  lost  a  cousin  with  Bright's  disease. 


430  WORRY  AND  NERVOUSNESS 

GETTING   DOWN   TO   BUSINESS 

Not  long  ago  after  listening  for  two  or  three  hours  to  a 
patient's  statement  of  her  troubles  and  difficulties,  (and  this  I 
always  do;  at  the  first  interview  allowing  the  patient  to  talk 
herself  out  —  literally  to  empty  her  mind  —  and  very  seldom 
interrupt  to  ask  a  single  question  until  the  story  is  finished)  I 
said  to  her :  "  Now,  I  appreciate  the  fullness  and  completeness 
with  which  you  have  told  your  story.  It  will  all  help  me  in 
helping  you.  I  think  I  can  more  sympathetically  plan  and  carry 
forward  your  treatment,  but  now  what  I  want  you  to  do  is  to 
take  all  these  troubles  and  difficulties  which  you  have  recited  to 
me  in  detail  and  write  them  down,  if  possible  on  a  single  sheet 
of  paper,  that  we  may  get  right  down  to  business  and  directly 
attack  something  definite.  Mind  you,  get  them  on  one  sheet  of 
paper  if  possible,  and  I  will  give  you  just  one  week  in  which  to 
do  this.  Be  back  here  one  week  from  today  with  this  written 
statement  and  you  shall  have  your  first  lesson."  And  this  is  the 
intelligent  and  concise  statement  that  was  handed  me  at  the  time 
of  the  patient's  next  visit: 

I  have  reached  the  conclusion  that  my  troubles  are  the  result  of  the 
following  faults  in  the  working  of  my  mental  machinery: 

i.  Self -Depreciation.  I  have  always  felt  that  people  did  not  like 
me,  that  I  was  not  attractive,  that  I  did  not  possess  the  qualities  that 
attracted  others.  I  have  a  cousin  living  near  us  who  is  considered 
very  good-looking  and  charming,  also  very  lively  and  has  always 
been  noticed  while  I  was  left  out  of  everything  and  people  have 
been  very  free  to  make  comparisons  between  us.  I  think  that  has 
been  a  great  factor  in  making  me  have  so  poor  an  opinion  of  my- 
self. Some  of  the  things  that  people  have  always  said  about  me 
that  hurt  me  are :  "  Nellie  takes  everything  too  seriously."  "  Oh, 
we'll  shock  Nellie."  "  Nellie  is  so  dignified."  "  Nellie,  what  makes 
you  so  quiet?  " 

2.  Self-Pity.  It  seems  quite  natural  that  I  should  feel  rather  sorry 
for  myself.  Why  should  I  not  be  just  as  clever  and  attractive  as  the 
other  members  of  my  family,  at  least.  I  have  always  considered  it 
rather  unfair. 

3.  Lack  of  Force.  I  feel  that  I  am  not  much  of  an  addition  to  a 
crowd.  Many  people  after  being  thrown  with  me  alone  enough  to 
get  acquainted  with  me  have  said :     "  I  never  noticed  you  before." 


WRITING  OR  ELIMINATION  CURE  43* 

"  Why  don't  you  let  yourself  out  more?  "  "  You  won't  let  people  get 
acquainted  with  you."  "  I  never  felt  that  I  knew  you  before."  One 
friend  said  "  You  ought  not  to  go  in  the  same  society  with  your  sister 
or  cousin,  you  show  off  so  much  more  when  they  aren't  around.'' 
I  said  that  was  impossible,  that  I  must  bring  myself  out  more  in 
some  way. 

4.  Distrust.     I  have  very  little  faith  in  people. 

5.  Indecision.  I  always  hate  to  have  to  make  a  decision  for  I 
nearly  always  regret  that  I  didn't  make  it  the  other  way. 

6.  Discontent.  Some  people  seem  to  have  the  ability  to  make  the 
best  of  what  they  have.  I  seem  to  have  trouble  that  way.  If  I  can't 
have  what  I  want,  I  don't  usually  want  what  I  can  have.  I  will  say 
I  have  overcome  these  faults  to  some  extent,  especially  in  the  last 
few  years. 

ELIMINATING  THEOLOGY 

We  find  that  a  great  many  of  our  neurasthenes  and  psychas- 
thenes  are  psychically  tortured  with  what  I  regard  as  "  theology 
worry."  I  have  never  run  across  many  patients  who  were  upset 
mentally  or  who  had  gone  crazy  over  simple  Christianity  —  that 
is,  the  plain,  straightforward  and  untwisted  teachings  of  Jesus 
Christ.  But  there  can  be  no  doubt  that  the  fearful  and  won- 
derful creations  of  the  sometime  theologians  have  done  much  to 
distress  and  disturb  the  minds  of  these  nervous  patients;  and 
in  the  treatment  of  these  cases  I  find  it  necessary  to  face  these 
things  squarely.  Accordingly,  at  the  proper  stage  of  the  treat- 
ment, I  direct  my  patients  to  prepare  a  written  and  definite 
statement  of  their  theological  troubles,  one  by  one,  for  I  long 
since  learned  to  my  sorrow  that  no  attempt  to  dodge  or  ignore 
these  spiritual  difficulties  in  the  mind  of  the  patient  will  ever 
be  attended  with  success.  Inharmonious  religious  emotions 
must  be  eliminated  in  order  to  effect  the  patient's  cure,  just  as 
surely  as  the  disharmonies  of  the  vocational,  domestic,  or  sex 
life  must  be  isolated  and  assimilated  or  eliminated.  The  follow- 
ing extract  from  a  patient's  "  confession  of  faith  "  is  an  illus- 
tration of  how  this  plan  works  out : 

I  believe  that  the  vicarious  blood  of  Christ  not  only  saves  my  soul 
but  also,  makes  me  a  joint  heir  with  Christ.  This  gives  me  every 
royal  privilege  and  prerogative.    I  believe  that  "  all  things  are  lawful 


432  JVORRVAXD  NERVOUSNESS 

but  all  things  are  not  expedient."  I  do  not  believe  that  the  royal 
child  of  a  royal  father  must  beat  on  the  doors  of  Heaven  nor  sacri- 
fice, crucify,  and  renounce  a  host  of  legitimate  desires  and  natural 
pleasures  to  assure  an  omniscient  God  and  loving  Father  that  his 
child  is  yielded  to  the  divine  Will.  This  seems  to  me  a  relic  of  bar- 
barism—  a  refined  form  of  beating  oneself  with  barbed  lashes  or 
walking  on  spikes  as  the  Oriental  devotee  does  to  gain  favor  with 
his  god. 

Without  understanding,  I  accept  the  Bible  from  cover  to  cover. 
I  believe  that  the  laws  of  God  are  immutable— His  natural  laws  as 
well  as  his  spiritual  laws.  I  believe  that  the  Christian  should  be  ab- 
solutely without  care.  I  believe  that  his  first  duty  is  love  and 
obedience  toward  God.  and  the  next,  love  and  service  to  his  fellow 
creatures.     In  these  lie  the  source  of  true  joy. 

I  believe  that  Christ  is  coming  again  to  receive  all  of  his  own 
—  weak  and  strong.  As  to  the  "baptism  of  the  Spirit"  which 
I  have  accepted  by  faith.  I  do  not  know  whether  to  call  it  a  second 
work  of  grace  or  a  fuller  development  of  the  first  work.  I  lean 
toward  the  latter  thought.  Christ  seems  not  to  have  taught  two 
steps.  » 

If  meat  makes  my  brother  to  offend.  I  will  eat  no  meat.  This 
enters  into  all  my  ways  but  to  what  extremes  it  should  be  carried, 
I  don't  know. 

The  Bible  says  that  to  reign  with  Christ  I  must  suffer.  I  know 
that  this  cannot  mean  depression.  I  know  that  my  Master  meant 
that  I  should  be  happy  not  only  because  the  Bible  so  teaches,  but 
also. because  of  the  physiological  effect  of  a  joyful  spirit  on  the 
body. 

There  seems  to  be  an  opposing  force  continually  at  work.  When 
I  determinedly  closed  my  ears  to  this  evil  influence,  I  won  the 
day.  I  know  from  experience  that  pure  blood  and  excellent  cir- 
culation are  powerful  factors  in  the  fight  against  despondency. 
On  the  other  hand.  I  know  of  people  who  have  depleted  bodies, 
who  seem  never  depressed.  So  I  should  deduct  that  there  are 
other  conditions  beside  physiological  ones  to  be  dealt  with.  I  should 
think  that  the  wedge  of  faith  would  be  much  harder  to  drive  into 
a  permanent  position  than  would  a  wedge  of  fear.  Fear  is  a  weaker 
element  and  humanity  leans  toward  the  weaker  side.  I  suppose 
that  vou  plant  the  wedge  of  faith  by  systematic  and  continuous 
blows  of  the  right,  quality;  that  is.  positive  thoughts  of  an  optimistic 
nature.  I  can  see  how  both  wedges  could  be  sunk  into  the  brain,  or 
mind,  but  I  cannot  comprehend  the  wedge  of  fear  ever  being  totally 


WRITING  OR  ELIMINATION  CURE  433 

eradicated    except   by    eternal   vigilance   which    would    almost    spell 
fear. 

THE  REFLECTIONS  OF  A  PSYCHASTHENE 

In  the  first  year  of  the  management  of  a  case  of  typical 
psychasthenia,  I  have  followed  the  practice  of  seeing  the  patient 
on  an  average  of  about  once  in  two  weeks.  It  is  a  routine  prac- 
tice to  have  all  psychasthenes  keep  a  diary  for  the  first  year. 
This  diary  is  of  highest  value  both  to  patient  and  physician. 
That  other  psychasthenics  may  be  encouraged,  that  they  may 
appreciate  that  others  besides  themselves  have  a  long,  hard 
fight  that  runs  even  into  years,  and  that  they  may  further  appre- 
ciate that  even  in  the  most  difficult,  long  standing,  and  heredi- 
tary cases,  there  is  occasion  for  recognizing  improvement  from 
time  to  time;  and  further,  that  they  may  catch  the  spirit  of 
optimistic  courage  shown  by  the  first  year's  struggle  of  one 
of  the  most  difficult,  if  not  the  worst  case  of  psychasthenia  we 
have  dealt  with  for  several  years,  I  give  the  following  extracts 
taken  at  random  from  the  first  year's  diary  of  a  typical  psychas- 
thene,  who  has  fought  against  heavy  odds,  but  who  is  surely. 
even  though  slowly,  winning  her  fight;  and  as  far  as  it  is  pos- 
sible to  effect  a  cure  of  psychasthenia.  she  deserves,  and  I  think 
is  destined,  to  achieve  that  cure  in  time  and  find  herself  quite 
fully  restored  to  efficient  influence  in  her  family,  social,  and 
church  activities.  I  prefer  to  give  these  extracts  without  com- 
ment, merely  suggesting  to  the  reader  that  they  notice  the  slow, 
but  progressive,  growth  in  optimism,  self-understanding, 
patience,  and  self-confidence  in  ultimate  success. 

THE  THERAPEUTIC  DIARY 

Today  I  am  up  and  fully  dressed  for  the  first  time  in  four  weeks. 
It  does  seem  good  to  have  all  my  clothes  on,  and  the  family  appear 
to  appreciate  it  as  much  as  I  do. 

Xo  one  thing  that  money  could  buy  has  given  us  as  much  pleas- 
ure as  our  Victor-Victrola.  It  certainly  is  a  "  thing  of  beauty 
and  a  joy  forever."  While  we  ate  our  simple  meal  at  noon  today, 
we  listened  to  Schumann-Heink,  Evan  Williams,  Dr.  Gorgoza,  and 
some  of  the  Victor  opera  singers.  I  do  love  good  music,  it  is  one 
of  the   things   that   makes   life   worth   living,   and   will  be   enjoyed 


434  WORRY  AND  NERVOUSNESS 

by  us  even  more  I  believe  in  the  life  to  come.  Some  one  has  called 
it  the  "  pastime  of  eternity,"  and  surely  heaven  would  not  be  com- 
plete to  me  if  I  had  to  leave  music  behind. 

A  fitting  day  it  is  on  which  to  celebrate  Lincoln's  birthday.  As 
a  true  American  I  am  glad  to  honor  him  in  my  mind  today;  the 
more  I  read  about  his  life  the  more  it  appeals  to  me  as  being  truly 
great.  Surely  he  knew  what  it  meant  to  win  the  victory  in  spite 
of  obstacles,  and  I  should  like  to  have  some  of  that  same  spirit. 
Perhaps  one  who  has  to  battle  with  himself  is  as  truly  heroic  as 
one  who  fights  in  visible  warfare;  the  good  Book  says  "he  that 
ruleth  his  spirit  is  greater  than  he  that  taketh  a  city.  " 

Both  brain  and  body  seem  to  be  tired  out  today,  but  there  is  a 
feeling  of  relaxation  after  strain  that  is  far  from  uncomfortable 
and  I  am  experiencing  just  that  sensation. 

I  am  thankful  indeed  that  there  is  a  chance  for  me  to  learn  to 
live  differently,  and  am  beginning  to  see  how  it  would  pay  me  to 
go  through  a  process  of  reeducation,  even  if  the  uncomfortable  physi- 
cal symptoms  remained.  And  I  am  assured  that  they  cannot  all 
remain,  that  they  will  all  be  gone  when  the  new  education  displaces 
the  old,  so  there  will  be  a  double  joy  in  recovery.  After  all,  the 
victory  always  makes  the  battle  worth  while,  and  the  harder  the 
fight  the  sweeter  the  joy  of  winning. 

Some  one  has  said  that  the  surest  way  to  make  our  own  burdens 
seem  light  is  to  compare  them  with  those  of  other  people  who  have 
far  heavier  loads  to  carry,  and  I  suppose  that  is  a  legitimate  way 
of  consoling  ourselves.  Certainly  the  loss  of  a  night's  sleep  is  a 
very  small  thing  compared  to  the  losses  suffered  by  a  good  many 
people.  And  yet,  it  is  largely  because  I  am  so  anxious  to  get  well 
that  I  deplored  the  wakefulness.  It  has  been  comforting  to  be 
assured  that  as  long  as  one  can  rest  in  bed  the  loss  of  sleep  is  not 
particularly  harmful.  And  of  course  I  can  see  that  the  worry  or 
anxiety  about  it  is  worse  for  me  than  the  mere  staying  awake. 
Next  time  such  a  night  comes  I'll  try  to  remember  what  Mrs.  Wiggs 
said.  "  Don't  you  go  and  get  sorry  for  yourself.  That's  one  thing 
I  can't  stand  in  nobody.  There's  always  lots  of  other  folks  you 
kin  be  sorry  for  'sted  of  yourself." 

I  have  been  feeling  a  bit  discouraged  because  the  exhaustion 
has  been  so  pronounced  in  my  own  case  for  a  few  days,  but  a  few 


WRIT IX G  OR  ELIMINATION  CURE  435 

minutes'    talk    with   the   doctor   over   the    'phone   has   cheered   me 
greatly.     That  'phone  is  worth  its  weight  in  gold  at  times. 

It  is  such  a  comfort  to  feel  that  at  last  we  have  found  the  one 
who  knows  what  my  trouble  is  and  understands  hoiv  to  help  me 
out  of  it. 

When  I  realize  how  much  I  have  to  learn,  and  how  slow  the 
process  is,  it  is  easier  for  me  to  be  patient  with  the  children. 
Perhaps  my  guidance  of  them  will  be  wiser  because  I  am  "  in 
training"  myself.  I  am  thankful  for  the  Providence  that  led  us  to 
our  doctor  and  I  expect  to  get  well  under  his  care. 

My  heart  goes  out  to  all  who  suffer,  and  when  I  am  still  stronger 
I  mean  to  do  all  I  can  to  lessen  the  misery  and  increase  the  happi- 
ness in  the  world.  Sometimes  I  wonder  if  God  is  not  leading  me 
through  troubled  waters  just  so  I  may  be  able  more  efficiently  to 
help  others. 

I  must  confess  to  more  or  less  excitement  today  due  to  the 
prospect  of  a  trip  downtown  tomorrow  ;  that  is  not  surprising  when 
one  remembers  that  two  years  have  elapsed  since  my  last  trip 
down.  I  am  eager  to  see  the  doctor  and  take  another  step  towards 
getting  well. 

Today  finds  me  somewhat  weary  but  quite  happy  because  yes- 
terday spelled  z-ictory  for  me.  I  actually  went  downtown,  spent 
an  hour  and  a  half  in  the  doctor's  office,  and  returned  home  without 
any  undue  nervous  disturbance.  Really,  I  am  not  sure  that  I  did 
not  enjoy  it  a  little  bit. 

The  talk  with  the  doctor  was  a  great  satisfaction,  in  fact  it  is 
solid  comfort,  after  years  of  misunderstanding,  to  feel  myself  in 
the  hands  of  one  who  perfectly  understands  both  the  cause  and  the 
cure  of  my  long  and  stubborn  illness.  I  was  so  anxious  to  see  him 
again  and  he  gave  me  so  much  to  think  about  when  I  did  see  him, 
that  the  trip  down  and  back  seemed  only  incidental.  Surely  that 
means  progress.  I  felt  surprised  when  it  was  over  to  see  how  I 
had  taken  the  journey  as  a  matter  of  course. 

A  few  years  ago  a  new  plaything  appeared  on  the  market  and 
immediately  became  popular.  Like  many  other  new  (?)  fashions, 
it  was  really  nothing  more  than  the  revival  of  an  old  one.  but  was 
none  the  less  pleasurable  for  that,  and  people  old  and  young  began 


436  WORRY  AXD  NERVOUSNESS 

working  on  jig-saw  puzzles.  To  me  they  were  a  veritable  God- 
send, for  they  came  just  at  the  time  when  I  was  most  in  need  of 
some  recreation  that  would  not  tax  me  mentally  and  yet  be  divert- 
ing enough  to  cause  me  to  forget  myself.  Many  a  day,  when 
reading  or  sewing  or  music  seemed  impossible,  I  was  able  to  lose 
myself  entirely  in  hunting  for  the  next  piece. 

"  Man's  extremity  is  God's  opportunity."  Yesterday  was  either 
the  worst  day  I've  had  in  months  or  the  best,  and  I  would  rather 
think  it  was  the  latter.  Nervously  I  was  "  down  and  out "  actually 
drunk  from  loss  of  sleep  and  nerve  tension,  for  I  staggered  once 
or  twice  in  walking  down  the  hall.  The  skies  seemed  dark  in- 
deed, and  I  tired  myself  out  trying  to  solve  the  problem  which  has 
baffled  me  so  long.  Then  God  sent  an  angel,  a  "  really  truly  "  angel 
dressed  in  woman's  clothes  as  a  disguise,  but  it  was  not  hard  to 
recognize  in  her  a  messenger  straight  from  above.  She  gave  me 
her  own  secret  of  living  a  happy  care- free  life,  a  real  child  life 
spiritually  and  it  is  a  secret  worth  knowing.  As  never  in  my  life 
before,  I  grasped  the  truth  that  the  God  who  can  help  and  can 
heal,  is  not  far  away  on  a  throne,  loving  but  distant,  but  he  is 
right  with  me  all  the  time,  caring  for  me.  leading  me.  holding  me 
fast,  understanding  me.  His  everlasting  arms  are  holding  me  and 
he  fully  knows  the  physical  and  nervous  and  mental  conditions, 
and  loving  me  all  the  time. 

The  disappointment  of  having  symptoms  persist  for  weeks  and 
render  me  miserable  has  been  almost  more  than  I  could  bear.  I 
expected  "  off-days  "  and  nights  too,  to  occur  once  in  a  while,  but 
I  did  not  look  for  any  long  continued  spell  of  trouble,  and  its  sig- 
nificance has  doubtless  been  magnified  just  because  of  that. 

I  believe  the  secret  of  my  doctor's  success  lies  in  the  fact  that 
he  knows  how  to  handle  patients  without  antagonizing  them,  for 
in  spite  of  myself,  I  resent  the  advice  given  by  well  meaning  friends. 

He  said  once  that  "  I'd  get  well  if  he  should  fall  down  dead." 
but  I  hope  he  lives.  I  really  think  I'm  the  worst  case  he  has  though 
it  may  not  seem  so  to  him.  With  all  due  respect  to  him  I'm  afraid 
he  will  find  it  difficult  if  not  impossible  to  teach  this  "old  dog 
new  tricks." 

I  can  see  that  I  have  been  too  much  troubled  by  unruly  emotions, 
failing  to  realize  that  they  are  often  the  result  of  purely  physical 
causes  and  in  no  wise  affect  my  relations  to  God.     I  shall  have  to 


WRIT IX G  OR  ELIMIXATIOX  CURE  437 

let  Him  manage  emotions,  also,  for  I  cannot  do  it  alone,  I've  been 
trying  it  for  years. 

If  I  could  only  lose  the  sense  of  effort,  I  doubt  not  I  could  make 
more  progress.  Like  Paul  I  feel  that  "  when  I  would  do  good 
evil  is  present  with  me,"  and  discouragement  seems  to  be  present 
all  of  the  time.  The  other  day  I  came  across  this  sentence:  "When 
all  other  compensations  fail,  there  is  always  this  left,  that  nothing 
lasts  forever."  That  is  about  all  my  solace  today,  for  this  hot,  hot 
south  wind  must  be  included  and  I  know  when  it  stops  we  shall 
all  feel  better. 

In  looking  over  my  record  for  the  past  week  or  so,  I  am  struck 
by  the  complaining  tone  of  some  of  the  entries.  Guess  I'll  have 
to  change  my  tune  and  write  down  the  bright  spots. 

Right  on  top  of  that  last  entry  I  had  a  very  bad  night,  no  sleep 
at  all,  hard  crying  spell,  rebellion,  resentment,  and  discouragement 
all  running  riot  until  it  seemed  as  if  seven  devils  had  entered  into 
me.  An  unseemingly  Fourth  of  July  celebration,  surely,  for  I 
did  not  feel  my  "  independence  "  at  all.  The  day  was  one  of  intense 
heat,  which  did  not  mend  matters.  A  friend  came  in  to  dine  with 
us  informally  and  began  to  tell  of  her  summers  spent  upon  her 
brother's  farm  near  Traverse  City,  Michigan.  The  more  I  thought 
of  it,  the  more  intense  became  the  longing:  result,  a  telegram  sent 
to  the  farm  announcing  our  coming.  We  took  a  sleeper  at  Engle- 
wood,  rode  all  night,  reached  Traverse  City  at  6  a.  m.  Sunday, 
drove  four  miles  out  to  the  farm  before  breakfast,  all  without  any 
particular  discomfort  on  my  part  except  inability  to  sleep  on  the 
train.  When  I  realize  that  it  was  only  in  March  that  I  made  my 
first  trip  downtown  and  considered  it  a  great  feat,  it  does  seem 
that  I  must  have  made  some  progress;  to  come  three  hundred  and 
sixty  odd  miles  away   from  home  without  minding  it. 

I  have  been  walking,  climbing  hills,  playing  croquet,  rowing  and 
auto  riding,  all  in  moderation  for  I  find  even  yet  that  I  am  not  as 
strong  as  I  look.  The  hammock  under  the  apple  tree  is  a  favorite 
refuge,  a  good  part  of  the  time. 

And  so  we  took  the  children  for  a  picnic  supper  and  went  to 
the  park  for  a  few  hours  and  ventured  out  on  the  lake  for  a  launch 
ride  — on  the  big  lake  I  mean,  which  is  sure  proof  of  returning 
courage  on  my  part. 


438  WORRY  rAND  NERVOUSNESS 

The  family  are  being  granted  an  immediate  proof  of  my  being 
better  while  they  cannot  see  the  good  this  writing  does.  It  is  a 
pleasure  to  get  into  the  kitchen  with  a  gingham  apron  on  and  a  big 
spoon  in  my  hand  and  stir  a  boiling  mass  of  stuff  that  is  to  be 
enjoyed  all  through  the  coming  winter.  I  do  not  see  how  an  after- 
noon spent  at  bridge  can  compare  with  it  for  interest,  besides  I  am 
reasonably  sure  of  winning  the  prize  myself  if  I  am  careful  to  use 
the  correct  formula. 

And  so  I  went  to  the  party.  When  I  rang  the  bell,  who  should 
come  to  the  door  but  our  family  physician  himself,  and  the  look 
on  his  face  was  worth  going  a  mile  or  two  to  see.  He  could  hardly 
"  believe  his  own  eyes  "  as  the  children  say,  and  finally  remarked, 
"Well,  you  are  doing  more  than  you  used  to  do,  aren't  you?" 
I  said  I  thought  so  for  I  had  made  my  second  trip  to  town  just 
two  days  before.  He  did  not  have  to  tell  me  that  he  was  very  greatly 
surprised  to  see  me,  but  when  he  said  just  that  I  remembered  hear- 
ing Dr.  S.  say,  "  and  your  friends  are  going  to  be  surprised,  too." 

I  seem  to  be  having  as  many  moods  as  the  weather  this  week  — 
possibly  the  weather  is  responsible  for  my  variations.  Yesterday 
the  air  was  so  warm  and  heavy,  I  felt  tired  to  an  extreme,  and 
depressed,  more  or  less,  mentally  as  well.  The  cooler  atmosphere 
today  is  welcome,  and  yet  I  find  it  hard  to  shake  off  wholly  either 
the  exhaustion  or  the  depression.  Never  mind,  it  is  all  a  part  of  the 
game,  and  I  am  going  to  win  out  some  day.  Sometimes  I  have  a 
curious  sense  of  duality,  a  feeling  that  my  real  self  and  my  nervous 
self  are  entirely  apart  and  distinct,  and  are  at  war  with 
each  other.  When  the  nerves  are  having  their  way  and  winning 
out  for  the  time  being,  at  first  I  begin  to  feel  discouraged,  and 
then  a  realization  of  the  true  situation  comes  and  I  feel  like  say- 
ing, "Very  well-,  it  will  be  my  turn  next,  and  some  day  I'll  have 
you  so  badly  beaten  you'll  have  to  stay  down  for  good." 

Another  rainy  day!  I  am  glad  for  more  reasons  than  one  that 
I  made  ray  trip  downtown  yesterday;  it  is  hard  to  realize  that  it  is 
myself  who  has  made  three  trips  down  in  just  a  little  over  a  month. 
The  only  part  of  it  that  bothered  me  at  all  was  having  to  wait  for 
the  doctor  again,  and  perhaps  that  is  good  discipline.  The  confer- 
ence with  Dr.  S.  was  satisfactory,  especially  his  parting  word :  "  I 
can  see  nothing  that  is  not  favorable  to  your  recovery."  The  best 
part  of  it  is,  that  when  I  stop  to  look.  I  can  find  nothing  unfavorable 
myself,  and  so  I  am  quite  ready  to  believe  his  statement. 


WRITING  OR  ELIMINATION  CURE  439 

It  might  be  a  good  scheme  to  write  up  my  good  days  with  red 
ink  and  my  bad  ones  with  blue,  then  a  glance  through  the  book 
would  show  the  progress  of  events.  Perhaps  in  time  the  quantity 
of  red  ink  would  be  hard  on  one's  eyes,  so  we'll  be  satisfied  to 
keep  a  somber  record. 

After  such  a  full  day  and  half  hour's  sociability  in  the  evening, 
I  might  have  stayed  awake  all  night;  instead  I  slept  like  a  top,  and 
today  I  am  only  tired,  not  tired  out.  After  my  unwonted  exertions, 
surely  I  must  be  better.  I  really  expected  to  feel  worse  than  I 
have. 

Everything  considered,  I  have  stood  the  past  week  very  well,  hav- 
ing been  hopeful  and  cheerful  and  philosophical  most  of  the  time. 
I  can  recall  only  one  spell  of  depression. 

A  fresh  page  and  a  new  book!  I  wonder  what  story  will  be 
written  herein,  how  many  ups  and  downs  will  be  recorded,  how 
many  tales  of  victory  and  defeat?  Of  one  thing  I  feel  certain, 
that  progress  will  be  written  whether  swift  or  slow  and  that  the 
end  of  this  third  note  book  will  proclaim  me  nearer  my  goal. 

Two  whole  days  have  slipped  away  since  my  last  entry  and  busy 
ones  they  have  been.  It  is  such  a  pleasure  to  find  myself  able  to 
do  a  little  work  without  going  all  to  pieces  after  it. 

I  have  noticed  that  it  is  usually  the  little  things  in  life  that  upsets 
us  most,  just  as  a  pin  prick  will  some  times  hurt  more  than  a  deep 
cut.  It  may  be  because  we  have  a  multiplicity  of  small  hardships 
to  bear,  while  great  trials  come  but  seldom.  At  any  rate  in  a  well 
ordered  life,  one  must  take  things  as  they  come  and  yield  grace- 
fully to  what  is  inevitable  and  cling  steadfastly  _to  the  faith  that 
"  all  things  are  working  together  for  good." 

It  is  hard  to  determine  which  is  more  uncomfortable,  the  nerv- 
ous tension  which  makes  sleep  almost  an  impossibility  or  the  reac- 
tion following  it  which  causes  one  to  feel  stupid  and  half  asleep 
all  day  long.  Both  are  part  of  the  "  game  "  I  suppose,  and  this 
game  was  not  invented  for  the  sake  of  one's  personal  enjoyment. 
Moreover,  even  well  people  have  good  days  and  bad  ones  and  will 
have  until  the  end  of  time,  so  it  is  not  a  matter  to  trouble  me. 
I  do  not  get  so  far  down  as  I  used  to  go,  and  bob  up  more  quickly, 
so  there  is  a  gain. 


44o  WORRY  AND  NERVOUSNESS 

Well,  of  all  the  mean,  miserable,  contemptible,  persistent  things 
that  ever  laid  hold  of  a  poor  human  being,  psychasthenia  is  the 
worst!  There  are  not  enough  adjectives  in  the  English  language 
to  describe  its  mean  qualities.  It  has  been  having  fun  with  me  the 
last  few  days,  to  my  chagrin.  Just  as  I  get  to  thinking  that  the 
troublesome  nerves  are  about  dead  and  buried,  up  they  jump  and 
dance  a  two-step  on  the  grave  and  I  have  to  look  on  whether  I 
am  so  inclined  or  not. 

Able  to  sleep  again  at  last!  And  I  do  feel  better,  not  only  be- 
cause I  have  had  two  good  nights'  rest,  but  especially  so  because 
I  discovered  the  cause  of  the  recent  spell  of  wakefulness  and  was 
able  to  remedy  it.  At  any  rate  my  trouble  was  undoubtedly  due 
to  a  local  congestion,  probably  caused  by  cold,  which  in  turn  was 
probably  caused  by  the  weather.  The  weather  conditions  on  Sat- 
urday and  Sunday  were  enough  to  upset  an  elephant.  Now,  I 
know  the  truth  and  can  still  believe  myself  better,  not  well  yet,  or 
probably  so  small  a  cause  would  not  have  kept  me  awake. 

a  neurologist's  advice 

There  recently  came  to  my  desk  a  very  interesting  little  work 
on  "  nerves "  consisting  of  letters  from  neurotic  patients  in 
connection  with  the  neurologist's  replies.  One  of  the  neurolo- 
gist's letters,  the  reply  to  the  plaintive  plea  of  a  psychasthene, 
I  regard  as  especially  good;  in  fact  so  good  that  I  present  the 
following  extracts: 

I  am  in  somewhat  of  a  quandary  whether  I  shall  tell  you  the 
name  that  we  physicians  give  to  the  disorder  from  which  you  suf- 
fer, or  whether  I  shall  endeavor  to  put  before  you  certain  rules  of 
life  and  conduct,  conformation  to  which  may  restore  you  to  a  life 
of  usefulness  and  comparative  happiness.  If  I  do  the  first,  I  must 
warn  you  against  looking  up  the  writings  upon  the  subject,  and 
applying  the  statements  to  be  found  therein  to  yourself.  You  know, 
I  am  sure,  that  few  things  warp  our  judgment  so  much  as  illness, 
and  especially  illness  within  the  mental  sphere.  There  is  a  custom 
that  few  physicians  transgress,  and  that  is  not  to  undertake  to 
treat  themselves  when  they  are  ill.  The  physician  whose  training 
and  life-habit  is  to  deal  with  disease,  finds  that  this  is  the  safest 
and  most  expeditious  course  to  pursue  in  order  to  regain  health, 
and  the  layman  need  not  hesitate  to  follow  his  lead.  I  shall,  how- 
ever, be  very  frank  with  you  in  the  discussion  of  your  infirmities, 


WRITING  OR  ELIMINATION  CURE  441 

and  endeavor  to  put  before  you  the  nature  of  your  disorder  in  such 
a  way  that  you  will  comprehend  it.  Nothing  aids  the  physician 
so  much  in  his  fight  with  disease  as  intimate  acquaintanceship  with 
the  malady  and  a  full  understanding  of  its  nature.  When  he  comes 
to  deal  with  a  disorder,  whose  cure  requires  the  intelligent  coopera- 
tion of  the  patient,  it  is  of  the  greatest  value  that  the  patient  should 
have  a  fairly  clear  conception  of  the  disease. 

The  symptoms  which  you  describe  have  probably  been  known  to 
physicians  since  the  beginnings  of  medicine.  Although  we  do  not 
find  them  mentioned  in  the  medical  literature  of  the  ancients,  we 
frequently  read  of  such  symptoms  in  the  biographies  of  men  whose 
names  have  become  immortal.  Men  and  women  of  genius,  men 
and  women  who  write  their  names  indelibly  upon  the  scroll  of 
time,  are  usually  individuals  of  nervous  temperament,  or  neurotic 
constitution,  of  neuropathic  diathesis;  and  although  it  is  in  spite  of, 
and  not  by  virtue  of  this  that  they  achieve  fame  and  add  to  the 
luster  of  their  times  and  to  the  welfare  of  the  world,  neverthe- 
less it  would  seem  that  the  greatness  of  their  endowment  nearly 
always  carries  with  it  the  drawbacks  inseparable  from  such  a  tem- 
perament. I  do  not  by  any  means  intend  to  convey  the  idea  that 
men  of  genius  must  necessarily  have  symptoms  such  as  those  you 
relate.  It  is  only  lately  that  physicians  have  realized  that  symptoms 
such  as  yours  are  the  expression  of  a  neuropathic  diathesis  or 
constitution  which  has  not  been  properly  disciplined  by  hygienic 
measures. 

The  problem  that  we  neurologists  most  frequently  have  to  solve 
is,  how  to  arrange  the  life  of  the  patient  who  consults  us,  so  that 
his  career  shall  not  be  a  failure.  Unfortunately,  we  do  not  get 
the  individual,  as  a  rule,  until  after  he  has  fully  matured  and  be- 
come a  creature  of  fixed  habit.  We  are  in  the  position  of  a  skilled 
watchmaker,  who  has  been  handed  a  chronometer  of  which  every 
part  seems  to  be  perfect,  but  which  nevertheless  will  not  do  the 
work  for  which  it  was  intended,  or  else  does  the  work  in  an  erratic 
and  unreliable  manner.  The  watchmaker  gives  very  little  satisfac- 
tion if  he  says  that  a  certain  bit  of  steel  used  in  the  construction 
was  not  adequately  tempered,  or  a  certain  coiled  spring  was  not 
properly  annealed.  He  must  do  something  that  will  make  the  watch 
keep  accurate  time,  and  in  order  to  accomplish  this,  he  must  attack 
it  fundamentally,  take  it  to  pieces,  and  proceed  from  the  very  foun- 
dation. 

A  somewhat  similar  course  must  be  pursued  by  the  physician  who 
essays  to  treat  such  constitutional  disorders  as  psychasthenia.     He 


442  WORRY  AXD  NERVOUSXESS 

must  attack  the  patient  fundamentally,  dissect  his  character,  ferret 
out  the  primordial  origins  of  his  false-beliefs,  analyze  the  remote 
antecedents  of  his  first  obsessions,  go  back  to  the  early  times  when 
it  was  admitted  that  effect  naturally  followed  cause.  To  be  quite 
normal  one  must  emulate  the  young  child  or  the  animal  and  be  un- 
self-conscious.  There  was  a  time  when  even  the  germs  of  your 
present  distressing  ideas  and  sensations  did  not  exist.  Therefore, 
endeavor  to  determine  what  their  antecedents  were,  and  having 
found  them  treat  them  as  enemies.  It  is  largely  a  matter  of  self- 
cure,  particularly  for  a  man  who  like  yourself,  has  the  dual  advan- 
tage of  intelligence  and  a  trained  mind.  You  will  be  assisted  in  the 
matter  by  a  course  of  appropriate  reading,  carefully  selected  and 
faithfully  pursued.  An  adequate  philosophy  is,  in  reality,  what  you 
are  in  search  of,  and  I  should  recommend  to  you  a  careful 
study  of  Aristotle  and  Epicurus.  You  can  find  amongst  the  writ- 
ings of  the  latter  this  statement:  "We  should  not  be  hampered  by 
foolish  fears  from  attaining  the  goal  of  our  existence  —  happiness. 
Pleasure  is  the  highest  good ;  not  the  pleasure  accompanying  a  pass- 
ing sensation,  but  pleasure  as  a  permanent  state  —  that  state  of 
deep  peace  and  perfect  contentment  in  which  we  feel  secure  against 
the  storms  of  life." 

If  you  can  take  the  point  of  view  which  Aristotle  took,  that  the 
mind  does  not  originally  possess  ready-made  ideas  but  the  faculty 
of  forming  them,  it  will  help  you  very  much  in  getting  rid  of  these 
obsessions  that  have  fastened  themselves  upon  you  like  barnacles 
on  the  bottom  of  a  ship. 

What  can  you  do  directly  to  help  yourself?  You  must  make  a 
firm  resolution  that  at  certain  times  in  the  day  you  will  dislodge 
these  ideas  from  your  mind  by  force  of  will.  A  repetition  of  this 
effort  will  render  their  dissociation  more  and  more  easy  and  their 
recurrence  more  and  more  infrequent. 

"  Refrain  tonight, 

And  that  shall  lend  a  kind  of  easiness 

To  the  next  abstinence ;  the  next  more  easy, 

For  use  can  almost  change  the  stamp  of  nature." 

You  will  find,  moreover,  that  you  will  gain  greatly  by  translating 
your  thoughts  into  some  form  of  action,  instead  of  bottling  them 
up  and  turning  them  over  and  over  in  your  mind.  In  other  words, 
if  you  are  able  to  embody  your  thoughts  in  speech,  in  efforts  for  the 
benefit  of  others,  in  anything  that  has  a  definite  purpose,  it  will  be 
of  service  to  you. 


WRITING  OR  ELIMINATION  CURE  443 

The  truth  of  the  matter  is  that  a  man  like  you  should  no  more 
need  an  outsider's  help  to  overcome  his  symptoms  than  to  cure 
him  of  swearing,  or  of  boasting,  of  a  belief  in  ghosts  or  in  spiritual- 
ism. You  wouldn't  send  for  a  surgeon  if.  having  a  thin  skin,  you 
got  a  sliver  in  your  finger.  You  would  set  to  work  to  remove  it 
yourself,  and  in  nine  instances  out  of  ten,  you  would  succeed.  You 
may  regret  you  have  a  thin  skin,  but  you  soon  learn  to  take  precau- 
tions not  to  injure  it. 

SUMMARY   OF   THE    CHAPTER 

1.  The  "  elimination  cure  "  of  worry  and  the  nervous  states  is 
practiced  by  encouraging  free  expression  of  emotion,  by  the 
means  of  writing,  talking,  and  praying. 

2.  The  "  writing  cure  "  is  practiced  by  directing  the  patient 
to  present  written  theses  from  time  to  time  dealing  with  special 
phases  of  his  experiences. 

3.  Many  neurasthenes  and  all  psvchasthenes  are  directed  to 
keep  a  therapeutic  diary  during  the  early  part  of  their  active 
treatment. 

4.  This  diary  serves  a  double  purpose;  first,  as  a  means  of  ex- 
pression and  elimination  for  the  patient;  second,  as  a  guide  to 
the  physician  in  the  matter  of  treatment. 

5.  Before  discharging  a  patient  as  cured,  we  frequently  ask 
him  to  write  a  "  graduation  thesis,"  in  which  he  outlines  the 
causes  of  his  trouble  as  well  as  the  methods  by  which  his  cure 
has  been  effected. 

6.  When  a  patient's  written  statement  shows  he  understands 
his  disease  just  about  as  well  as  the  physician,  he  is  ripe  for  dis- 
missal —  he  is  practically  cured. 

7.  Auto-psychanalysis  is  carried  out  by  instructing  the  patient 
in  psycho-analysis  and  then  later  have  him  submit  a  written  state- 
ment embodying  the  results  of  his  mental  explorations. 

8.  Disorder  and  disharmony  in  the  religious  emotions  are  some- 
times responsible  for  worry  and  nervousness,  as  well  as  disturb- 
ances in  the  business,  domestic  and  sex  life  of  the  patient. 

9.  After  the  nervous  patient  has  freely  '*  talked  out  "  his 
troubles,  it  is  a  good  plan  for  him  to  "  get  down  to  business  "  and 
prepare  a  written  resume  of  his  story  for  the  physician. 

10.  I  sometimes  ask  such  patients  to  make  a  categorical  state- 
ment of  their  troubles,  confining  the  same  to  one  or  possibly  two 
sheets  of  paper. 

11.  In  unusually  bad  cases  I  limit  my  request  for  written  state- 
ments to  a  single  subject  or  phase  of  their  difficulties.  They  are 
always  successful  in  complying  with  this  request. 

12.'  This  '"Writing  cure"  helps  the  patient  actually,  literally, 


444 


WORRY  AND  NERVOUSNESS 


and  visibly,  to  get  things  "  out  of  the  system ;  "  and  with  a 
tor's  aid  to  get  them  more  or  less  effectively  eliminated   and 
buried. 

13.  In  the  treatment  of  psychasthenia,  I  have  these  patients 
keep  up  this  "  therapeutic  diary  "  throughout  the  first  year  they 
are  under  observation. 

14.  The  perusal  of  a  psychasthene's  diary  would  put  to  shame 
the  average  neurasthene  or  other  nervous  worrier  who  is  but 
comparatively   mildly  afflicted. 

15.  In  the  "  writing  cure  "  for  eliminating  purposes,  the  patient 
must  be  cautioned  to  write  fully  and  sincerely  —  to  record  both 
the  good  and  the  bad. 

16.  The  psychasthenes  must  be  taught  to  live  a  philosophical 
life,  to  master  the  art  of  living  with  themselves  as  they  are  and 
the  world  as  it  is  —  to  live  in  the  future,  not  the  past. 

17.  We  must  constantly  remember  that  in  these  more  difficult 
nervous  disorders  we  are  treating  the  patient,  not  his  symptoms. 

18.  The  "  writing  cure  "  is  an  aid  to  the  patient  in  "  seeing 
himself  as  others  see  him,"  and  greatly  assists  the  physician  in 
detecting  how  far  the  patient  possesses  this  gift  of  self-recog- 
nition. 


CHAPTER  XXXIII 
THE  STUDY  OR  SUBSTITUTION  CURE 

WHEN  the  patient's  mind  is  filled  with  worry,  anxiety, 
fear,  and  evil  forebodings,  it  must  be  recognized  that 
these  undesirable  mental  states  cannot  be  overthrown  and  cast 
out  of  the  intellect  by  mere  resolution,  by  sheer  force  of  will- 
power. Other  better,  more  healthy,  and  stronger  ideas  must  be 
formulated  and  built  up  in  the  mind  to  take  the  place  of  their 
unhealthy  and  mischief-making  predecessors;  and  it  is  in  the 
work  of  substituting  good  ideas  for  bad  ones,  in  building  up 
healthy  and  helpful  complexes  to  displace  the  unhealthy  and 
diseased  ones,  that  systematic  study  and  carefully  planned 
courses  of  reading  prove  to  be  an  invaluable  aid. 

NATURE    STUDY 

There  are  some  fads  that  are  not  so  bad  after  all  for  the 
neurasthenic.  I  refer  to  the  nature  study  crazes  —  making  col- 
lections of  insects,  flowers,  mineral  specimens.  The  enthusiastic 
spirit  of  the  collector  is  highly  beneficial  even  if  not  employed 
in  such  uplifting  lines  as  nature  study.  Even  stamp  collecting, 
collecting  of  paintings,  china,  music,  or  oriental  rugs  are  all 
useful  therapeutic  diversions. 

There  is  much  help  to  be  had  from  the  study  of  books  on 
birds,  trees,  flowers,  animals,  bees,  all  phases  of  geology,  biology, 
astronomy  —  anything  in  fact  that  will  get  the  patient's  mind 
off  himself  and  onto  the  great  big  world  and  the  greater  and 
bigger  universe  of  which  it  is  a  part.     (Fig.  18.) 

I  must  in  this  connection,  however,  warn  my  readers  against 
overwork  —  nervous  exhaustion,  against  too  long  walks  and  too 
intent  application  even  in  the  pursuit  of  these  curative  fads. 

Nature  study  is  a  splendid  substitute  for  the  mirror  habit, 
the  habit  nervous  sufferers  have  of  gazing  at  themselves  in  a 

445 


446  WORRY  AND  NERVOUSNESS 

mirror  and  then  indulging  in  self-pity.  It  is  better  to  carry  a 
field  notebook  and  make  notes  on  nature  than  to  indulge  in  the 
habit  of  so  many  nervous  people  of  making  notes  on  their 
nervous  symptoms.  Nature  field  work  further  necessitates  the 
patient's  dressing  in  healthful  and  comfortable  clothes  and 
spending  considerable  time  in  the  open  air. 

DEPRESSING    LITERATURE 

In  this  connection  let  me  warn  my  nervous  readers  against 
suggestive  literature  of  the  pessimistic  sort,  particularly  the 
sex-and-soul  variety,  and  I  think  I  also  ought  to  advise  against 
too  much  reading  of  medical  works  and  books  highly  descriptive 
of  nervous  disorders.  I  am  admonished  even  while  writing  this 
present  book  of  the  necessity  of  exercising  great  care  that  while 
I  am  helping  one  nervous  sufferer,  I  do  not  contribute  to  the 
miseries  of  another. 

Wholesome  wit,  as  well  as  works  on  travel  and  other  branches 
of  literature  pertaining  to  science  study,  will  all  be  found  divert- 
ing and  helpful. 

It  is  very  necessary  carefully  to  select  and  scrutinize  the 
literature  which  is  intended  for  the  neurasthenic's  consumption. 
It  is  even  necessary  personally  to  discriminate  in  this  matter,  as 
certain  classes  of  reading  which  may  be  entirely  beneficial  to 
a  large  group  of  neurasthenes  may  not  be  at  all  suited  to  some 
particular  individual ;  and,  therefore,  nervous  patients  should 
refrain  from  reading  all  sorts  of  books  which  depress,  excite, 
or  otherwise  tend  to  increase  their  anxiety  and  nervousness. 

THE  ANCIENT  PHILOSOPHERS 

YYe  must  admit  that  many  of  the  ancient  philosophers  had 
some  very  clear  and  helpful  views  along  the  lines  we  have  under 
present  consideration,  and  since  there  is  a  peculiar  fascination 
for  things  which  are  old,  whether  they  are  old  ruins  or  old 
authors,  I  find  it  very  helpful  to  have  my  nervous  patients  who 
enjoy  reading  occasionally  go  through  the  writings  of  these  old- 
time  philosophers.  It  is  diverting,  fascinating,  and  there  is  so 
much  that  is  genuinely  helpful  that  it  makes  the  research  well 
worth  while.     As  an  example  let  me  cite  the  following  passages 


« 


Associate  with  the  Birds 
FIG.  18.  THE  CURATIVE  POWER  OF  NATURE  STUDY 


THE  STUDY  OR  SUBSTITUTION  CURE 


447 


from  Marcus  Aurelius,  the  old  pagan  philosopher,  which  the 
worrier  should  read  often  and  remember  long: 

Do  not  disturb  thyself  by  thinking  of  the  whole  of  thy  life.  Let 
not  thy  thought  at  once  embrace  all  the  various  troubles  which 
thou  mayest  expect  to  befall  thee;  but  on  every  occasion  ask  thy- 
self, What  is  there  in  this  which  is  intolerable  and  past  bearing? 
For  thou  will  be  ashamed  to  confess.  In  the  next  place,  remember 
that  neither  the  future  nor  the  past  claim  thee,  but  only  the  pres- 
ent. But  this  is  reduced  to  a  very  little  if  thou  only  circumscribest 
it  and  chidest  thy  mind  if  it  is  unable  to  hold  out  against  even  this. 

Or,  as  the  philosopher  elsewhere  says : 

Let  not  the  future  things  disturb  thee,  for  thou  will  come  to  them 
if  it  shall  become  necessary,  having  with  thee  the  same  reason 
which  now  thou  usest  for  present  things ;  for  what  need  is  there 
of  suspicious  fear,  since  it  is  in  thy  power  to  inquire  what  ought 
to  be  done?  And  if  this  thou  seest  clear,  go  by  this  way  content, 
without  turning  back;  but  if  thou  dost  not  see  clear,  stop  and  take 
the  best  of  advisers.  But  if  any  other  thing  oppose  thee,  go  on  ac- 
cording to  thy  powers  with  due  consideration,  keeping  to  that  which 
appears  to  be  just.  For  it  is  best  to  reach  this  object,  and.  if  thou 
dost  fail,  let  thy  failure  be  in  attempting  this.  He  who  follows  rea- 
son in  all  things  is  both  tranquil  and  active  at  the  same  time,  and  also 
cheerful  and  collected. 

Marcus  Aurelius  also  commented  upon  a  phase  of  the  nervous 
mind  that  is  always  pronounced  —  the  tendency  to  irritation  at 
the  unseemly  conduct  of  others: 

When  thou  art  offended  with  any  man's  seemless  conduct  immedi- 
ately ask  thyself,  Is  it  possible  that  shameless  men  should  not  be  in 
the  world?  Let  the  same  consideration  be  present  in  thy  mind  as 
in  the  case  of  the  knave  and  the  faithless  man,  and  of  every  man 
who  does  wrong  in  any  way. 

THE    ROLE    OF    AMBITION 

While  it  is  the  over-ambitious  who  are  so  frequently  the  vic- 
tims of  nervous  breakdowns,  nevertheless,  even  though  ambi- 
tion may  be  a  common  cause  of  neurasthenia,  I  am  forced  to 
recognize  that  it  is  also  many  times  the  cure,  especially  in  those 
mild  and  chronic  cases  which  are  of  the  hereditary  or  psychas- 


448  WORRY  AXD  NERVOUSNESS 

thenic  sort.  Regular  and  systematic  courses  of  reading  directed 
along  the  lines  of  the  optimistic  literature  —  books  on  efficiency, 
social  service,  and  other  of  the  newer  avenues  of  human  activ- 
ity, are  all  helpful  in  stimulating  the  confirmed  neurasthene  to 
bestir  himself  and  make  an  effort  to  rise  above  his  chronic 
depression.  Literature  of  this  sort  is  often  able  to  supply  some 
new  incentive  to  action,  to  depict  new  realms  for  exploration 
and  conquest. 

Books  are  an  excellent  companion  for  semi-neurasthenics,  and 
are  of  great  service  in  helping  them  to  acquire  an  enlarged  view- 
point of  life,  to  broaden  their  mental  horizon.  A  calm,  dispas- 
sionate outlook  upon  the  world  is  an  essential  part  of  mental 
hygiene,  and  so  far  from  this  attitude  being  impossible  in  our 
busy,  workaday  world,  mental  poise  may  be  maintained  even  by 
the  most  strenuous,  provided  one  keeps  within  the  bounds  of 
temperance,  and  limits  his  desires  to  those  things  which  are 
easily  obtained.     The  value  of  ambition  is  not  to  be  discounted. 

But  the  ambition  must  not  be  for  the  conquest  of  impossible  worlds. 
That  ambition  which  has  for  its  object  the  accumulation  of  material 
wealth  and  fame  is  bound  to  end  in  disappointment,  for  following 
the  achievement  of  ambition,  when  it  is  too  late  to  find  new  worlds 
to  conquer,  there  comes  always  a  blank.  Back  of  the  desire  for 
money  and  fame  should  always  be  found  the  real  ambitions  of 
life,  the  cultivation  of  the  things  that  belong  to  the  spirit.  Ambi- 
tions of  this  kind  are  never  satisfied;  the  greatest  satisfactions  come 
of  a  growing  mind  and  of  new  intellectual  reactions  to  life,  in  a  mind 
thus  trained  material  failures  being  incapable  of  producing  bitter- 
ness and  disappointment. 

This  fact  explains  how  it  comes  about  that  men  whose  lives 
have  been  filled  with  intellectual  interests  grow  old  more  grace- 
fully and  possess  greater  poise  than  they  whose  years  have 
been  filled  with  worry  and  thought  for  business  or  for  the 
acquisition  of  fame. 

REGULARITY    IN    READING 

I  find  it  best  for  the  nervous  patient  to  set  aside  regular 
periods  for  reflection,  reading,  and  study.  The  early  morning 
hours  are  in  many  ways  preferable,  were  it  not  for  the  fact  that 


THE  STUDY  OR  SUBSTITUTION  CURE         449 

so  many  nervous  patients  do  not  feel  as  well  in  the  morning 
as  they  do  later  on  in  the  day.  I  therefore  advise  my  nervous 
patients  to  set  aside  for  their  main  study  hour  those  portions 
of  the  day  in  which  they  feel  possessed  of  the  most  mental 
energy.  As  a  rule  I  think  it  is  best  for  the  really  nervous 
sufferers  not  to  read  continuously  over  thirty  minutes  at  one 
time,  although  there  are  patients  who  can  read  one-half  day 
at  a  time  without  apparent  hurt  to  their  nerves.  At  any  rate, 
systematic  effort  at  mental  culture,  sober  reading  as  well  as 
diverting  literature,  should  be  indulged  in  according  to  the  needs 
of  each  particular  patient. 

It  is  surprising  to  see  how  much  time  people  are  willing  to 
devote  to  some  minor  accomplishment  and  how  little  to  the 
culture  of  mind-control  and  the  development  of  one's  real 
character.  Young  girls  will  be  kept  working  for  hours  and 
hours  practicing  at  the  piano  by  parents  who  are  highly  solici- 
tous that  they  become  accomplished  musicians,  but  seem  to  be 
little  concerned  whether  or  not  they  become  proficient  in  mind- 
control  and  masters  of  the  all-important  science  of  character 
building. 

LIGHT  LITERATURE 

In  the  nervous  states  we  must  recognize  that  the  more  recently 
developed  and  higher  intellectual  powers  are  the  ones  most 
easily  fatigued;  that  the  more  philosophical,  reasoning,  and 
discriminating  mind  centers  are  those  most  largely  out  of  com- 
mission. Therefore,  in  selecting  a  course  of  reading  for  the 
average  neurasthenic,  psychasthenic,  or  hysteric  patient,  it  is 
necessary  to  bear  these  facts  in  mind  and  recognize  the  im- 
portance of  choosing  those  books  which  do  not  so  largely  tax 
or  so  highly  excite  these  newer,  and  hence  more  easily  and 
highly  fatigued,  mind  centers.  In  other  words,  neurasthenes 
enjoy  best  and  are  most  greatly  benefited  by  that  literature  of 
a  light  or  juvenile  order,  simple  stories,  unexciting  and  non- 
morbid  novels,  tales  of  adventure  and  exploration  when  not  too 
exciting,  simple  and  popular  science  books,  and  optimistic  and 
inspirational  religious  writings;  in  fact,  all  the  literature  that 
would  be  appropriate  for,  and  enthusiastically  enjoyed  by,  a  child 


450  WORRY  AND  NERVOUSNESS 

from  ten  to  fourteen  will  be  found  most  suited  to  the  first  sys- 
tematic reading  course  of  the  confirmed  neurasthene ;  and  from 
month  to  month  and  from  year  to  year,  the  depth,  scope,  and 
philosophy  of  his  reading  may  be  broadened  from  time  to 
time  to  meet  his  increasing  powers  of  attention  and  psychic 
assimilation. 

The  reader  will  no  doubt  expect  me  in  this  connection  to 
recommend  a  list  of  books  to  be  used  for  this  purpose  and  such 
a  list  would  no  doubt  be  of  some  value,  but  I  am  forced  to 
recognize  that  there  would  be  so  many  good,  useful,  and  appro- 
priate books  not  in  my  list  that  I  feel  it  would  be  an  injustice  to 
literature  to  make  such  a  recommendation,  and,  further,  I  am 
beginning  to  recognize  that  the  nervous  patient  needs  this  very 
experience  of  developing  his  initiative  —  of  finding  out  for  him- 
self what  is  best  for  him,  suitable  and  helpful ;  in  other  words, 
it  is  with  the  "  reading  cure  "  like  all  other  phases  of  treatment 
in  neurasthenia  —  it  is  the  patient  zi'ho  must  be  set  in  motion  to 
work  out  his  ozen  cure.  He  must  merely  be  provided  with  a 
medical  compass  which  gives  him  his  main  therapeutic  direction, 
and  it  is,  to  use  a  phrase  of  the  street,  "  up  to  him  "  to  find  his 
way  out  of  the  jungle  of  "nerves"  into  the  promised  land  of 
physical  poise  and  mental  self-mastery. 

MATHEMATICS  AND  POETRY 

At  first  thought  it  might  seem  strange  to  recommend  simul- 
taneously the  study  of  mathematics  and  poetry  as  a  part  of  the 
"  reading  cure "  for  the  nervous  states,  but  it  will  not  seem 
strange  when  the  motive  for  this  prescription  is  explained. 

The  study  of  mathematics  —  phases  adapted  to  the  patient's 
mental  state  and  previous  education  —  is  a  most  excellent 
means  of  developing  the  memory,  of  increasing  and  strengthen- 
ing the  power  of  mental  concentration,  both  of  which  are  appar- 
ently decreased  in  the  average  nervous  patient.  Mathematics 
is  an  excellent  memory  developer,  and  when  the  neurasthene 
sees  his  memory  improving,  he  is  tremendously  encouraged  and 
enthusiastically  throws  himself  into  new  efforts  to  gain  the 
mastery  of  his  nerves.  Just  as  a  suddenly  failing  memory  is  a 
great   cause   for   discouragement  to  the  average   neurasthenic, 


THE  STUDY  OR  SUBSTITUTION  CURE         451 

so  the  phenomenon  of  increasing  or  returning  memory  is  a 
source  of  tremendous  encouragement. 

Every  neurotic  individual  needs  to  have  a  healing  balm  for 
his  emotional,  his  sentimental,  or,  perchance,  his  artistic  tem- 
perament, and  this  may  be  adequately  supplied  by  the  literature 
which  has  been  handed  down  to  our  generation  by  the  poets  of 
the  past.  If  the  physician  can  find  just  the  right  sort  of  poetry 
for  use  in  his  "  reading  cure,"  it  sometimes  works  like  magic. 
I  have  not  infrequently  observed  the  neurasthenic  patient  in  the 
midst  of  a  week  of  great  despondency  and  discouragement,  come 
into  the  office  some  morning  all  brightened  up  and  either 
verbally  to  quote  or  to  place  upon  my  desk  an  extract  from  some 
poem  which  he  had  run  across  just  the  day  before,  with  this 
statement:  "  I  have  been  getting  worse  and  worse,  Doctor,  for 
a  week  or  ten  days,  until  I  ran  across  this  bit  of  poetry  yester- 
day and  it  just  cheered  me  right  up  —  I  brightened  right  up  and 
I  have  been  feeling  better  ever  since." 

And  so  we  can  often  achieve  a  double  purpose  in  having  our 
patients  commit  poetry  to  memory.  The  memory  is  strength- 
ened, they  are  thereby  cheered;  the  mind  is  distracted,  they  are 
therefore  relieved  from  the  horrors  of  self-contemplation, 
their  sentiment  and  emotions  are  occupied  and  exercised  and 
they  are  in  that  way  relieved  from  the  emotional  isolation  which 
is  so  highly  detrimental  to  neurotic  people. 

BIBLE   STUDY 

Of  all  phases  of  the  "  reading  cure  "  which  have  been  attended 
with  surprising  results,  I  must  first  mention  the  systematic  study 
of  the  Bible.  Xow,  one  must  be  careful  in  prescribing  Bible 
study  as  part  of  the  treatment  of  neurasthenia.  Certain  nerv- 
ous, hyperconscientious  and  over-religious  patients  may  be 
greatly  harmed  by  having  their  minds  altogether  focused  upon 
Bible  study  and  the  reading  of  religious  literature.  On  the  other 
hand,  many  nervous  patients  who  are  spiritually  starved,  men- 
tally underfed,  find  great  help  and  encouragement  in  the  daily 
and  systematic  reading  of  the  Bible.  I  am  specially  fond  of 
recommending  the  Psalms,  the  Book  of  Job,  the  Prophet  Isaiah, 
the  Gospel  of  John,  and  the  Epistles  of  St.  Paul, 


452  WORRY  AND  NERVOUSNESS 

I  find  it  advisable  in  many  cases  definitely  to  recommend  to 
these  timid,  fearful,  and  over-anxious  patients,  some  definite 
passages  from  the  Holy  Writ  which  are  peculiarly  adapted  to 
strengthening  their  faith  and  courage.  Among  those  texts 
which  I  have  most  commonly  used  for  this  purpose,  I  cite  the 
following 

EXCEEDING    GREAT    AND    PRECIOUS    PROMISES 

But  as  many  as  received  him,  to  them  gave  he  power  to  become 
the  sons  of  God,  even  to  them  that  believe  on  his  name.  —  Jno. 
I  :i2. 

For  by  grace  are  ye  saved  through  faith;  and  that  not  of  your- 
selves: it  is  the  gift  of  God.  —  Eph.  2:8. 

lie  that  covereth  his  sins  shall  not  prosper:  but  whoso  confesseth 
and  forsaketh  them  shall  have  mercy.  —  Pro  v.  28:13. 

He  looketh  upon  men,  and  if  any  say,  I  have  sinned,  and  per- 
verted that  which  was  right,  and  it  profited  me  not;  he  will  deliver 
his  soul  from  going  into  the  pit  and  his  life  shall  see  the  light.  — 
Job  33  .27,  28. 

If  we  confess  our  sins,  he  is  faithful  and  just  to  forgive  us  our 
sins,  and  to  cleanse  us  from  all  unrighteousness.  —  I.  Jno.  1  :o. 

For  if  there  be  first  a  willing  mind,  it  is  accepted  according  to  that 
a  man  hath,  and  not  according  to  that  he  hath  not. —  II.  Cor.  8:12. 

In  the  last  day,  that  great  day  of  the  feast,  Jesus  stood  and  cried, 
saying,  If  any  man  thirst,  let  him  come  unto  me,  and  drink.  —  Jno. 

7-37- 

All  that  the  Father  giveth  me  shall  come  to  me;  and  him  that 
cometh  to  me  I  will  in  no  wise  cast  out.  —  Jno.  6:37. 

But  if  we  walk  in  the  light,  as  he  is  in  the  light,  we  have  fellow- 
ship one  with  another,  and  the  blood  of  Jesus  Christ  his  Son 
cleanseth  us  from  all  sin.  —  I.  Jno.  1:7. 

For  God  so  loved  the  world,  that  he  gave  his  only  begotten  Son, 
that  whosoever  believeth  in  him  should  not  perish,  but  have  everlast- 
ing life.  —  Jno.  3:16. 

The  thief  cometh  not  but  for  to  steal,  and  to  kill,  and  to  destroy: 
I  am  come  that  they  might  have  life,  and  that  they  might  have  it 
more  abundantly.  I  am  the  good  shepherd :  the  good  shepherd  giveth 
his  life  for  the  sheep.  —  Jno.  10:  10,  11. 

Who  are  kept  by  the  power  of  God  through  faith  unto  salvation 
ready  to  be  revealed  in  the  last  time.  —  I.  Pet.  1:5. 

I  have  written  unto  you,  fathers,  because  ye  have  known  him  that 


THE  STUDY  OR  SUBSTITUTIOX  CURE         453 

is  from  the  beginning.  I  have  written  unto  you,  young  men,  be- 
cause ye  are  strong,  and  the  word  of  God  abideth  in  you,  and  ye 
have  overcome  the  wicked  one.  —  I.  Jno.  2:14. 

Who  hath  delivered  us  from  the  power  of  darkness,  and  hath 
translated  us  into  the  kingdom  of  his  dear  Son.  —  Col.  1:13. 

He  giveth  power  to  the  faint ;  and  to  them  that  have  no  might  he 
increaseth  strength.  —  Isa.  40:29. 

And  God  is  able  to  make  all  grace  abound  toward  you;  that  ye, 
always  having  all  sufficiency  in  all  things,  may  abound  to  every  good 
work. —  II.  Cor.  9:8. 

For  he  shall  give  his  angels  charge  over  thee,  to  keep  thee  in  all 
thy  ways.  They  shall  bear  thee  up  in  their  hands,  lest  thou  dash 
thy  foot  against  a  stone.  —  Ps.  91:11,  12. 

For  I  am  not  ashamed  of  the  gospel  of  Christ:  for  it  is  the  power 
of  God  unto  salvation  to  every  one  that  believeth;  to  the  Jew  first, 
and  also  to  the  Greek.  —  Rom.  1:16. 

Ho,  every  one  that  thirsteth,  come  ye  to  the  waters,  and  he  that 
hath  no  money ;  come  ye,  buy  and  eat ;  Yea.  come,  buy  wine  and  milk 
without  money  and  without  price.  —  Isa.  55:1. 

And  the  Spirit  and  the  bride  say.  Come.  And  let  him  that  heareth 
say,  Come.  And  let  him  that  is  athirst  come.  And  whosoever  will, 
let  him  take  the  water  of  life  freely.  —  Rev.  22:17. 

Who  shall  separate  us  from  the  love  of  Christ?  shall  tribula- 
tion, or  distress,  or  persecution,  or  famine,  or  nakedness,  or  peril, 
or  sword?  As  it  is  written,  For  thy  sake  we  are  killed  all  the 
day  long:  we  are  accounted  as  sheep  for  the  slaughter.  Nay,  in 
all  these  things  we  are  more  than  conquerors  through  him  that  loved 
us.  For  I  am  persuaded,  that  neither  death,  nor  life,  nor  angels, 
nor  principalities,  nor  powers,  nor  things  present,  nor  things  to  come, 
nor  height,  nor  depth,  nor  any  other  creature,  shall  be  able  to  sepa- 
rate us  from  the  love  of  God,  which  is  in  Christ  Jesus  our  Lord. 
—  Rom.  8:35-39- 

May  be  able  to  comprehend  with  all  saints  what  is  the  breadth, 
and  length,  and  depth,  and  height;  And  to  know  the  love  of  Christ, 
which  passeth  knowledge,  that  ye  might  be  filled  with  all  the  ful- 
ness of  God.  —  Eph.  3:18,  19. 

I  can  do  all  things  through  Christ  which  strengthened  me.  —  Phil. 
4:i3- 

If  the  Son  therefore  shall  make  you  free,  ye  shall  be  free  in- 
deed.—  Jno.  8:36. 

But  my  God  shall  supply  all  your  need  according  to  his  riches 
in  glory  by  Christ  Jesus.  —  Phil.  4:19. 


454  WORRY  AXD  XERVOVSXESS 

For  whatsoever  is  born  of  God  overcometh  the  world :  and  this 
is  the  victory  that  overcometh  the  world,  even  our  faith.  —  I.  Jno. 

5-4- 

Then  spake  Jesus  again  unto  them,  saying,  I  am  the  light  of  the 
world  :  he  that  followeth  me  shall  not  walk  in  darkness,  but  shall 
have  the  light  of  life.  — Jno.  8:12. 

For  I  reckon  that  the  sufferings  of  this  present  time  are  not  worthy 
to  be  compared  with  the  glory  which  shall  be  revealed  in  us.  — 
Rom.  8:18. 

Confirming  the  souls  of  the  disciples,  and  exhorting  them  to  con- 
tinue in  the  faith,  and  that  we  must  through  much  tribulation  enter 
into  the  kingdom  of  God.  —  Acts  14:22. 

Behold,  I  stand  at  the  door  and  knock:  if  any  man  hear  my  voice, 
and  open  the  door,  I  will  come  in  to  him,  and  will  sup  with  him, 
and  he  with  me.  —  Rev.  3  :20. 

Create  in  me  a  clean  heart,  O  God;  and  renew  a  right  spirit 
within  me. —  Ps.  51:10. 

Wait  on  the  Lord:  be  of  good  courage,  and  he  shall  strengthen 
thine  heart:   wait.  I  say,  on  the  Lord.  —  Ps.  27:14. 

Behold.  God  is  my  salvation  ;  I  will  trust,  and  not  be  afraid :  for 
the  Lord  Jehovah  is  my  strength  and  my  song;  he  also  is  become 
my  salvation.  —  Isa.  12:2. 

Come  unto  me.  all  ye  that  labour  and  are  heavy  laden,  and  I  will 
give  you  rest.  Take  my  yoke  upon  you.  and  learn  of  me ;  for  I  am 
meek  and  lowly  in  heart;  and  ye  shall  find  rest  unto  your  souls. — 
Matt.  11  :28.  29. 

Peace  I  leave  with  you,  my  peace  I  give  unto  you :  not  as  the 
world  giveth.  give  I  unto  you.  Let  not  your  heart  be  troubled, 
neither  let  it  be  afraid.  —  Jno.  i4:-7- 

There  hath  no  temptation  taken  you  but  such  as  is  common  to 
man:  but  God  is  faithful,  who  will  not  suffer  you  to  be  tempted 
above  that  ye  are  able;  but  will  with  the  temptation  also  make  a 
way  to  escape,  that  ye  may  be  able  to  bear  it.  —  I.  Cor.  10:13. 

And  the  inhabitant  shall  not  say.  I  am  sick :  the  people  that  dwell 
therein  shall  be  forgiven  their  iniquity.  —  Isa.  33  -.24. 

Arise,  shine;  for  thy  light  is  come,  and  the  glory  of  the  Lord 
is  risen  upon  thee.  —  Isa.  60:1. 

DAILY  READING  PROGRAM 

As  a  sample  of  the  "  reading  cure  "  as  an  auxiliary  in  the 
treatment  of  neurasthenia,  I  will  here  give  a  reading  course  I 


THE  STUDY  OR  SUBSTITUTIOX  CURE         455 

have  just  prescribed  for  a  patient,  a  married  woman,  twenty- 
seven  years  of  age,  who  had  practically  given  up  all  reading 
for  the  past  three  years,  and  has  been  bedridden  most  of  the 
time.     I  have  given  her  the  following  course: 
Monday : 

9:30  A.  M.     Read  first  chapter  in  the  Gospel  of  John. 

2  :oo  P.  M.     Following  noonday  nap.    Thirty  minutes  reading 
of  favorite  novel. 

7:30  P.M.     Memory    exercise.      Commit    to    memory    first 
twenty  lines  of  Hiawatha. 
Tuesday : 

9  130  A.  M.     Read  second  chapter  in  the  Gospel  of  John. 

2  :oo  P.  M.     Xature  study.     First  three  chapters  of  book  on 
ants. 

7 130  P.  M.     Memory    exercise.      Problems    in    mental    arith- 
metic  (under  direction  of  patient's  husband). 
Wednesday : 

9:30  A.  M.     Read  third  chapter  in  Gospel  of  John. 

2  :oo  P.  M.     Thirty   minutes   reading  in  popular   Astronomy. 

7:30  P.M.     Memory  exercise.     Review,  recite,  and  commit 
to  memory  twenty  lines  more  of  Hiawatha. 

This  program  will  be  kept  up  until  the  book  of  St.  John  is 
finished.  Two  times  a  week  at  the  afternoon  hour  the  reading 
will  be  left  optional  to  be  devoted  to  magazines,  novels,  or  any- 
thing the  patient  may  choose  or  happen  to  be  interested  in. 
The  evening  hour  will  be  devoted  continuously  to  the  memory 
study  exercises,  alternating  between  mathematics  and  poetry. 
Of  course,  if  the  patient  already  knows  Hiawatha,  some  other 
poem  that  has  a  fascinating  jingle  or  rhyme  could  have  been 
prescribed,  such  as  Snowbound  or  Evangeline.  These  courses 
of  reading  must  be  carefully  adapted  to  the  mental  and  physical 
strength  of  the  patients.  Their  tastes  should  also  be  consulted. 
I  sometimes  find  it  best  to  use  prose  instead  of  poetry  in  the 
case  of  men  who  always  have  prided  themselves  on  the  fact 
that  they  were  not  interested  in  poetry;  and  I  have  many  times 
found  that  history  is  more  interesting  to  some  patients  than 
even  nature  study.  I  choose  to  have  the  memory  exercises 
practiced  in  the  evening  because  of  the  fact  that  the  neuras- 


456  WORRY  AXD  NERVOUSNESS 

thene's  mind  is  usually  strongest,  most  active  and  in  best  shape 
at  the  close  of  the  day.  I  have  further  observed  that  these 
evening  memory  exercises  produce  a  healthy  sort  of  mental 
weariness,  which,  when  not  overdone,  is  a  great  aid  in  bring- 
ing about  a  good  night's  sleep. 

SUMMARY   OF  THE    CHAPTER 

1.  Worry  and  anxiety  cannot  be  driven  out  of  the  mind  by 
mere  resolution  or  sheer  force  of  will-power. 

2.  The  study  cure  is  a  sort  of  substitution  treatment  —  an 
effort  to  displace  mischief-making  complexes  by  wholesome  and 
helpful  thoughts  acquired  through  systematic  reading. 

3.  Nature  study  represents  one  of  the  most  highly  beneficial 
methods  of  carrying  out  the  "  reading  cure  "  for  nervousness. 

4.  The  collecting  craze  is  good  for  neurasthenia,  and  it  mat- 
ters little  whether  one  collects  paintings,  china,  rugs,  insects, 
flowers,  or  stamps. 

5.  Neurasthenics  must  be  warned  against  both  exciting  and 
depressing  literature,  particularly  the  sex-and-soul  variety. 

6.  Nervous  patients  should  be  discouraged  in  the  reading  of 
medical  books,  especially  those  medical  works  which  are  sug- 
gestive of  diseases  which  the  neurasthene  may  readily  imagine 
he  has. 

7.  Wholesome  wit  and  humor,  together  with  works  on  travel 
and  adventure  are  all  diverting  and  helpful. 

8.  The  works  of  many  of  the  ancient  philosophers,  like  Marcus 
Aurelius,  are  all  useful  in  occupying  and  diverting  the  mind. 

9.  While  overexertion  may  be  a  cause  of  neurasthenia,  never- 
theless, well-directed  and  intelligent  ambition  is  invariably  an 
essential  part  of  the  cure. 

10.  Books  are  a  good  companion  for  the  neurasthenic.  Regu- 
lar and  systematic  courses  of  "  optimistic  literature  "  are  inspir- 
ing and  stimulating  to  the  nervous  patient. 

11.  Give  attention  to  regularity  in  reading,  set  aside  two  or 
three  regular  short  study  periods  each  day. 

12.  The  "  reading  cure  "  should  be  practiced  as  a  therapeutic 
recreation  and  when  overdone,  is  liable  to  become  depressing 
and  injurious. 

13.  The  ideal  literature  for  confirmed  neurasthenics  is  that 
which  would  be  appreciated  and  enjoyed  by  youths  from  ten 
to  fourteen  years. 

14.  The  '''reading  cure"  aids  in  setting  the  patient  in  motion 
along  the  lines  of  working  out  his  own  cure. 

15.  The  study  of  some  phase  of  mathematics  —  mental  arith- 
metic —  is  an  excellent  memory  strengthener  and  developer. 


THE  STUDY  OR  SUBSTITUTION  CURE         457 

16.  Xeurasthenes  can  both  strengthen  their  memory  and  cheer 
themselves  up  by  the  practice  of  committing  to  memory  tune- 
ful poems  such  as  Hiawatha. 

17.  Daily  reading  of  the  Bible  is  very  helpful  to  the 
majority  of  neurotic  patients.  Special  promises  are  particularly 
helpful. 

18.  Chronic  worries  will  be  especially  benefited  by  the  study 
of  the  Psalms,  Isaiah,  John,  and  the  writings  of   St.  Paul. 

19.  In  the  practice  of  the  "  reading  cure  "  it  is  necessary  to 
set  aside  two  or  three  reading  periods  each  day,  and  follow  a 
carefully  prepared  program. 


CHAPTER  XXXIV 
THE  REST  OR  PLAY  CURE 

IN  USING  the  term  "  work  "  in  connection  with  the  treatment 
of  the  nervous  states,  I  desire  to  embrace  the  entire  realm  of 
productive  human  activities,  mental,  moral,  physical,  social, 
industrial,  and  political ;  while  by  the  term  "  rest  "  I  mean  to 
cover  the  entire  realm  of  physical,  mental,  and  spiritual  rest  and 
recreation,  even  to  include  the  realms  of  art  —  the  artistic  pur- 
suits. By  "  work,"  therefore,  we  refer  to  all  regular,  methodic, 
and  taxing  efforts  on  the  part  of  the  physical,  mental,  and  spir- 
itual powers ;  while  by  "  rest  "  we  refer  to  all  modes  of  relaxa- 
tion and  relief  from  the  tension  of  work,  whether  it  be  physical 
rest,  mental  diversion,  or  the  combined  rest  and  relief  of  all  the 
individual's  powers  by  means  of  recreation  —  common  play. 

THE   ISOLATION   REST   CURE 

In  a  former  chapter,  I  have  made  note  of  the  fact  that  I  do 
not  extensively  employ  the  Weir  Mitchell  Rest  Cure.  There 
are  many  cases,  however,  in  the  beginning  of  treatment,  which 
I  do  put  upon  a  modified  "  rest  cure  "  regime.  I  have  found  the 
rest  cure  for  these  patients  to  be  highly  successful  if  I  can  get  a 
nurse  on  the  job  who  understands  something  of  psychotherapy 
and  neurasthenic  human  nature.  Otherwise  I  have  come  to 
regard  the  isolation  of  the  "  rest  cure  "  as  highly  undesirable  in 
the  great  majority  of  these  cases. 

And  even  when  I  do  employ  the  old-fashioned  rest  cure  (keep- 
ing the  patient  in  bed,  not  allowing  him,  as  it  were,  to  lift  a 
hand),  I  do  not  practice  the  overfeeding  that  was  formerly 
employed.  I  feed  these  patients  well,  I  even  make  sure  to  over- 
feed them  a  trifle,  at  least  to  provide  from  fifteen  to  twenty 
per  cent  excess  of  calories  in  their  daily  rations.  As  soon  as  I 
have  accomplished  the  purpose  of  starting  the  patient  on   an 

453 


THE  REST  OR  PLAY  CURE  459 

increase  in  weight,  and  resting  the  jaded  nerves  for  a  period 
of  two  to  six  weeks,  I  then  gradually  transfer  the  patient  from 
the  "  rest  cure  "'  to  one  of  the  more  profitable  "  work  cures." 

THE  WEEKLY  REST  DAY 

The  average  neurasthenic  who  is  engaged  in  active  work  will 
do  well  to  observe  the  weekly  rest  day,  and,  if  possible,  avail 
himself  of  a  half  holiday  in  the  middle  of  the  week.  Concern- 
ing the  value  of  a  rest  day,  I  can  do  no  better  than  to  quote 
a  recent  editorial  in  the  Journal  of  the  American  Medical 
Association: 

The  refreshing  influence  of  the  weekly  recurring  "  day  of  rest " 
on  a  person  subjected  to  the  strenuous  routine  of  a  busy  life  is 
a  feature  which  he  himself  can  duly  appreciate  in  terms  of  his 
"feelings"  and  "spirits."  If  it  is  desired  to  demonstrate  the  need 
of  such  relaxation  and  the  benefits  derived  therefrom  in  some  objec- 
tive way,  a  method  is  not  easily  forthcoming.  The  problem  is  one 
which,  in  its  broadest  aspects,  has  a  far-reaching  importance  in 
every  community.  The  efficiency  of  the  working  man,  the  desirable 
length  of  the  working-day,  the  interjection  of  pauses  for  rest  in  the 
schedule  of  labor  for  persons  of  different  ages  and  stations  in  life 
—  questions  of  this  sort  are  constantly  arising  for  solution  by  some 
plan  which  excludes  purely  subjective  impressions  and  permits  some 
more  scientific  basis  for  a  tenable  judgment  in  the  matter.  Not 
only  in  the  field  of  manual  labor,  but  also  in  innumerable  other 
walks  of  life,  in  the  case  of  the  schoolchild,  the  office  boy,  the  fac- 
tory girl,  the  banker  and  the  merchant,  efficiency  is  the  keynote  of 
the  times.  Fatigue  is  the  enemy  of  efficiency;  and  to  detect  and 
compensate  for  or  overcome  it,  is  the  duty  of  those  concerned  with 
the  promotion  of  human  welfare. 

In  view  of  this  it  is  of  more  than  passing  interest,  from  the 
standpoint  of  both  public  and  personal  hygiene,  to  ascertain  suit- 
able methods  of  approach  to  the  problem  of  fatigue  and  the  les- 
sons which  it  discloses.  Dr.  Martin  and  some  of  his  associates 
in  the  Laboratory  of  Physiology  at  the  Harvard  Medical  School 
have  devised  a  satisfactory  procedure  for  estimating  variations  in 
electrocutaneous  sensibility  in  human  beings.  With  the  onset  of 
general  fatigue  a  progressive  rise  occurs  in  the  value  of  the  threshold 
stimulus.  This,  in  turn,  signifies  a  progressive  lowering  of  sensitive- 
ness, and,  according  to  the  view  of  Grabfield  and  Martin,  a  dimin- 


46o  IVORR  Y  AND  NER  VO  USNESS 

ishing  tone  of  the  nervous  mechanism  as  a  whole.  The  Harvard 
physiologists  have  made  a  long  series  of  experiments  on  first-year 
medical  students  in  good  health  who  were  following  a  regular  rou- 
tine of  school  work  during  six  days  of  each  week.  The  routine 
was  interrupted  weekly  by  the  Sunday  recess,  an  interval  occupied 
variously  by  the  students,  but  in  no  case  in  precisely  the  manner 
of  the  week  days.  The  daily  observations  made  on  these  persons 
during  several  weeks  show  that  at  the  beginning  of  the  week  the 
irritability  tends  to  be  high,  that  from  then  until  the  end  of  the 
week  there  is  a  fairly  continuous  decline  in  irritability,  as  judged 
by  the  sensory  threshold,  and  that  following  the  interruption  of 
the  routine  by  the  intervention  of  Sunday,  the  irritability  returns 
to  the  original  high  point. 

The  decline  in  irritability  is  interpreted  as  a  cumulative  result 
of  general  fatigue,  incident  to  routine.  What  is  even  more  signifi- 
cant, however,  is  the  added  fact  that  a  pronounced  break  in  the 
routine  —  such  as  the  ''day  of  rest"  occasions  —  may  bring  about 
a  return  of  sensitiveness  to  a  high  point  or,  in  other  words,  re- 
stores the  nervous  tone.  Studies  continued  in  this  direction  should 
lead  to  some  useful  conclusions  regarding  the  optimum  of  work, 
with  respect  to  both  its  duration  and  type,  that  should  determine 
the  conditions  under  which  the  organism  of  man  may  be  main- 
tained without  depletion. 

THE    PLAY    CURE 

And  so  while  some  bona  fide  nervous  invalids  may  stand  in 
real  need  of  the  so-called  medical  "  rest  cure,"  nevertheless  it 
has  been  my  experience  that  most  of  these  neurotic,  self-cen- 
tered, downcast,  and  discouraged  patients  need  to  engage  in  short 
periods  of  work  followed  by  free-hearted  and  enthusiastic  out- 
door play.  It  is  the  "  play  cure,"  when  suitably  adapted  to  the 
patient's  physical  strength  and  intellectual  tastes,  that  is  capable 
of  yielding  the  greatest  results  in  the  cure  of  the  nervous  states. 

In  the  light  of  all  that  we  have  previously  said  in  regard  to 
the  psychology  of  play,  it  must  be  evident  that  this  is  the  one 
universal  remedy  to  be  employed  in  neurasthenia  and  hysteria; 
in  fact,  if  there  is  one  real  sure  cure  for  the  nervous  states, 
it  is  the  scientific  and  sensible  blending  into  one  remedial 
regime  of  all  the  good  that  is  contained  in  the  "  work  cure  " 
and  the  "play  cure."     (Fig.  19.) 


THE  REST  OR  PLAY  CURE  461 

Recreation  and  outdoor  exercise  are  very  useful  in  building  up 
the  patient's  general  health.  One  of  the  common  causes  of 
nervousness  is  the  various  infectious  diseases,  whose  toxins 
lower  the  tone  of  the  nervous  system  and  greatly  reduce  the 
vital  resistance.  In  the  case  of  neurasthenics  and  others  whose 
nerves  are  not  hereditarily  strong,  emphasis  should  be  laid  on 
the  necessity  of  building  up  a  strong  reserve  force.  ^The  means 
to  this  end  are  the  very  measures  which  we  have  recommended 
in  an  earlier  chapter  —  baths,  wholesome  diet,  the  elimination 
of  poisonous  habits,  a  wholesome  frame  of  mind,  and  physical 
exercise.  It  is  important,  too,  that  the  patient  get  plenty  of  sleep. 
In  attempting  to  do  a  hard  day's  work  on  a  half  night's  sleep, 
one  is  drawing  on  his  vital  reserve  force,  and  when  this  occurs 
day  after  day,  with  no  opportunity  to  catch  up,  the  nervous 
system  is  bound  to  break  down.  Especially  is  this  true  if  the 
sleep  is  not  sound  —  and  in  most  cases  of  nervousness,  sleep  is 
not  sound.  And  here  we  find  that  "  benevolent  circles  "  are 
quite  as  possible  of  development  as  "  vicious  circles."  For  just 
as  a  weak  condition  of  the  nerves  will  produce  sleeplessness, 
and  sleeplessness  in  turn  increases  the  symptoms,  so,  in  the 
same  way,  an  improved  condition  of  the  nerves,  by  the  methods 
which  we  have  already  described,  will  make  for  sounder  sleep, 
sleep  in  turn  improving  the  condition  of  the  nerves,  and  the 
process  continuing  in  an  increasing  ratio  until  eventually  the 
patient  finds  his  nerve  tone  and  equilibrium  more  or  less  fully 
and  permanently  restored. 

In  beginning  the  fight  for  the  conquest  and  cure  of  "  nerves," 
the  patient  should  remember  that  his  "  nerves "  have  become 
disordered  not  by  a  single  act,  but  by  a  constant  violation  of  the 
laws  of  health,  extending  in  many  cases  over  a  period  of  years; 
and  so  the  very  best  of  curative  rules  are  quite  useless  for  a 
single  application.  In  attempting  to  regain  health,  the  neurotic 
must  weary  not  in  well  doing;  beneficial  effects  will  very  often 
appear  only  after  several  weeks  or  months  of  health  sowing; 
sometimes  the  simple  life  must  be  continued  for  years  before 
a  permanent  cure  is  effected.  But  we  venture  that  one  who 
persists  in  this  right  sort  of  living  will  find  the  increased 
pleasures   which   it  brings   ample  compensation   in   themselves, 


462  WORRY  AND  NERVOUSNESS 

quite  apart  from  the  restoration  of  nerves,  which  in  time,  is  . 
bound  to  come. 

ART    AND    PLAY 

Art  and  play,  as  we  understand  them,  have  the  same  purpose 
and  fulfill  the  same  functions  in  the  realms  of  health  and  thera- 
peutics. Their  purpose  is  to  relax  the  nerves,  relieve  tension, 
refresh  the' mental  powers,  and,  further,  to  divert  and  amuse  the 
intellect  while  supplying  only  wholesome  and  uplifting  themes 
of  thought  for  subsequent  contemplation. 

Work  embraces  those  essential  activities  which  make  for  the 
future,  they  have  a  purpose,  an  object;  while  play  represents 
that  whole-souled,  unhampered  expression  of  one's  mind,  body, 
and  soul,  which  has  no  other  object  in  the  world  than  the  com- 
fort and  satisfaction  of  this  unhindered  self-expression.  Play 
has  nothing  to  do  with  providing  a  livelihood,  recreation  has 
nothing  to  do  with  providing  for  future  needs;  even  art  may 
prove  to  be  a  cost  to  its  devotee  rather  than  a  source  of  income, 
and  when  it  does  become  a  means  of  livelihood  to  the  artist, 
then  art,  at  least  in  some  measure,  has  become  work  to  such 
an  individual  —  sometimes  hard  and  taxing  work  —  which 
causes  him  to  seek  other  and  minor  arts  as  a  means  of  recrea- 
tion—  as  his  relaxing  play. 

Of  course,  even  in  play  there  are  the  "  rules  of  the  game," 
and  while  we  derive  our  greatest  benefits  from  the  fact  that  we 
allow  our  emotions  and  impulses  to  gamble  about  unhampered 
and  gallop  off  at  full  pace,  nevertheless,  as  members  of  civilized 
society,  we  find  it  incumbent  upon  us  to  play  within  the  limits 
and  "  rules  of  the  game  " ;  within  those  limits  which  will  afford 
us  a  maximum  of  relief  from  restraint  and  the  greatest  possible 
pleasures  of  play,  with  a  minimum  of  interference  with  the  same 
and  equal  rights  of  our  fellow-beings. 

INARTISTIC    PLAYING 

While  all  forms  of  play  may  be  diverting  and  recreational  in 
their  influence,  yet  not  all  forms  of  play  are  uplifting  and 
ennobling.  There  are  the  "  scrappy  plays,"  those  games  and 
practices  which  young  boys  are  liable  to  fall  into  when  their 


THE  REST  OR  PLAY  CURE  463 

play  is  not  organized  and  directed  into  more  wholesome  chan- 
nels. They  are  diverting  for  the  time  being,  but  they  are  not 
satisfying  in  their  final  results  upon  the  individual's  mind  and 
character.  It  is  for  lack  of  organization  along  better  lines  that 
'"  gangs  "  of  boys  prowl  about  committing  acts  of  vandalism, 
torturing  dumb  animals,  and  committing  various  other  depreda- 
tions which  represent  the  spirit  of  play  manifesting  itself  in 
undirected  and  unsupervised  channels. 

Adults  in  the  same  mood  and  for  the  same  reasons  become 
fidgety,  nervous,  twiddle  their  thumbs ;  while  in  other  cases 
they  resort  to  gambling  and  other  forms  of  diversion  which  are 
able  to  hold  the  attention  of  the  mind  for  the  time  being,  but 
fail  in  the  fulfillment  of  that  great  function  of  play  which  is 
not  only  to  divert  but  to  satisfy  —  to  ennoble  —  and,  further,  to 
add  to  the  sum  total  of  one's  stock  of  good  nature,  good  humor, 
and  good  health. 

THE    SUGGESTION    ELEMENT    IN    PLAY 

One  of  the  great  elements  in  organized  "  rest  "  and  orderly 
"  play  "  is  the  incessant  striving  for  a  goal,  the  constant  effort 
to  attain  new  levels  of  proficiency  and  new  heights  of  accom- 
plishment. In  the  game  our  thought  is  ever  on  the  victory  we 
anticipate.  We  never  allow  our  minds  to  linger  on  the  defeat 
of  yesterday.  Again,  the  play-game  affords  us  an  opportunity 
of  impersonating  beings  different  from  and  greater  than  our- 
selves—  affords  the  opportunity  of  trying  to  do  the  thing  as 
well  as  someone  else  has  done  it  before  us,  encourages  one  even 
to  hitch  his  wagon  to  a  championship  star  and  aspire  to  do  it 
better  than  any  other  person  has  ever  done  it. 

Now,  it  is  highly  necessary  for  the  neurotic  patients  to  learn 
how  to  impersonate.  They  must  know  how  mentally  to  trans- 
form their  lives  before  they  will  ever  have  the  pleasure  of  seeing 
these  changes  wrought  out  in  their  experience.  There  is  a 
species  of  therapeutic  hypocrisy  which  every  nervous  patient 
must  learn  to  practice  upon  himself  or  herself.  They  must 
learn  to  say  they  are  calm  when  they  are  highly  agitated.  They 
must  learn  to  practice  these  gentle  arts  of  deception  upon  them- 
selves, practice  along  the  line  of  that  old  theory  that  "  by  behold- 


464  WORRY  AND  XERVOUSXESS 

ing  we  become  changed."  It  is  good  theology,  it  is  good 
psychology,  and  in  practice  it  proves  to  be  good  mental  medi- 
cine. Pick  out  the  kind  of  person  you  should  be  and  then  just  get 
right  down  to  business  and  make  believe  you  are  that  very  per- 
son—  impersonate  that  person's  calmness,  self-control,  and  nerv- 
ous equilibrium  —  and,  little  by  little,  you  will  be  surprised  to 
find  that  you  are  growing  into  the  similitude  and  likeness  of  the 
thing  you  have  persistently  impersonated. 

Not  long  since  I  had  a  well-known  actor  call  upon  me.  I  had 
not  seen  him  for  three  and  one-half  years,  and  when  last  I  had 
seen  him,  he  consulted  me  because  he  was  on  the  "  verge  of  a 
nervous  breakdown,'"  —  about  to  "go  to  piece-."  At  that  time 
I  gave  him  the  best  advice  I  could,  among  which  was  the 
following:  "Since  you  are  an  actor,  why  not  try  to  impersonate 
some  cool-mannered,  well-controlled  character  of  history  or 
literature  and  see  if  in  this  way  you  cannot  utilize  your  his- 
trionic abilities  for  some  valuable  therapeutic  purpose."  Xow, 
this  idea  seemed  to  take  hold  of  his  mind,  and  he  promised  me 
with  his  farewell  handshake  that  he  would  try  —  and  try  hard 
—  to  carry  out  my  advice;  and  at  the  time  of  his  recent  visit 
he  reported  to  me  that  he  found  the  method  of  some  value  and 
practiced  it  for  a  year,  but  was  still  very  nervous  and  restless; 
but  that  the  part  assigned  him  in  his  play  of  the  following  year 
was  just  such  a  character  —  just  such  a  calm,  composed, 
methodical,  and  beautifully  controlled  individual  —  and  he  now 
testifies  that  the  acting  of  this  part  through  a  single  season 
has  almost  entirely  cured  him,  that  he  succeeded  in  so  losing 
himself  while  impersonating  this  character  that  he  has  been 
able  to  carry  the  virtues  of  his  role  off  the  stage  and  use  them 
in  his  every  day  life.  In  other  words,  he  acted  the  part  so  well 
that  he  carried  it  off  the  stage  with  him.  he  lived  the  imper- 
sonated life  so  effectively  that  it  became  a  part  of  him:  yes, 
indeed,  it  became  himself  and  thus  his  neurasthenia  and  nervous- 
ness were  practically  cured.  And  so  all  neurasthenics  may  begin 
today  to  prove  themselves  marvelous  actors  and  actresses,  and, 
within  a  few  short  months,  be  able  so  to  transform  their  lives 
as  quite  fully  to  meet  their  patterns  and  ideals.  I  think  the 
next  great  move  in  the  cure  of  neurasthenia  will  be  to  establish 


THE  REST  OR  PLAY  CURE  465 

a  therapeutic  school  of  acting.  In  the  meantime  each  patient 
will  have  to  establish  his  own  studio  and  choose  his  own 
character. 

THE   ART   OF   GOOD    NATURE 

Many  a  nervous  patient  will  do  well  to  cultivate  the  simple 
art  of  being  good  natured,  for  we  must  recognize  that  to 
many  neurotics  good  humor  is  a  lost  art.  This  is  one  of  the  arts 
that  can  be  cultivated  at  home  and  without  expense.  This  sort 
of  "schooling"  does  not  involve  ocean  voyages  and  long 
sojourns  abroad  in  Paris  or  Berlin.  You  can  learn  how  to  be 
good  natured  right  at  home.  Someone  has  denned  a  good 
natured  person  as  one  who  is  '*  easy  to  please  and  hard  to 
sour."  Practice  being  content  while  cheerfully  playing  your 
role  in  life,  and  be  just  as  well  satisfied  with  a  good  natured 
minor  part  in  the  sociological  cast.  Be  just  as  happy  as  if  you 
were  acting  a  part  in  the  center  of  the  stage.  The  ever  present 
smile  is  the  badge,  the  trade  mark,  of  good  nature  and  good 
humor. 

It  is  about  time  we  reached  the  place  in  our  modern  civiliza- 
tion where  one  can  be  self-conscious  and  yet  happy,  where  one 
can  think  and  yet  be  natural  and  normal.  It  is  the  effort  to 
avoid  thinking  and  stifle  self-consciousness  that  characterizes 
much  of  the  oriental,  and  even  some  of  the  occidental  music 
and  other  theatric  accompaniments  of  so-called  art.  The  divert- 
ing and  quieting  effect  of  some  music  is  really  of  this  order, 
for  it  is  a  well-known  psychological  fact  that  any  well  marked 
and  monotonous  rhythm  containing  but  a  minimum  of  melody 
has  a  tendency  to  slow  down  the  mental  processes  and  favor 
sleep.  This  is  true  of  the  ticking  of  a  clock,  the  humming  or 
buzzing  of  an  insect,  or  the  regular  and  rhythmic  clank,  clank, 
of  the  sleeping-car  wheels  as  they  pass  over  the  rail  joints. 

I  have  sometimes  thought  that  good  humor  was  merely  the 
highest  attainment  of  good  manners.  It  certainly  is  of  great 
value  in  the  fight  against  neurasthenia  to  cultivate  the  habit  of 
being  extraordinarily  and  unusually  polite  to  one's  associates, 
friends,  employees,  etc.  A  grouch  seems  to  push  a  neurasthenic 
down  hill,  but  good  etiquette  seems  to  help  him  upward. 


466  WORRY  AXD  NERVOUSNESS 

I  knew  a  patient  several  years  ago  who  was  suffering  from  an 
incurable  illness,  who  was  confined  constantly  to  her  bed,  but 
she  was  seldom  alone,  as  the  entire  neighborhood  sought  her 
company,  she  was  so  cheering  in  her  conversation,  so  bright  and 
pleasant.  Her  face  always  wore  a  smile,  and  when  one  pauses 
to  consider  that  she  was  seldom  free  from  pain  it  was  a  revela- 
tion—  a  demonstration  —  of  the  fact  that  the  human  mind  can 
indeed  control  and  override  the  moods  and  sufferings  of  the 
physical  body.  One  day  I  asked  her  this  question:  "  Mrs.  V., 
how  is  it  that  you  can  be  so  happy  at  all  times,  so  cheerful  and 
inspiring  to  your  callers,  when,  as  a  physician,  I  know  you  are 
suffering  constant  pain,  and  when  I  further  know  that  you  know 
you  are  afflicted  with  an  incurable  disease,  and  that  you  can  only 
live  a  few  years  at  most,  and  that  your  pain  will  last  to  the 
end?"  And  this  was  her  reply:  "I  remember,  Doctor,  when 
I  was  a  little  girl  I  used  to  carry  flowers  to  a  kind  old  lady 
who  must  have  been  afflicted  much  as  I  am  now,  and  I  came  to 
look  upon  her  as  the  best  friend  I  had  in  the  world  outside  of  my 
mother.  I  can  never  forget  her  kind  advice,  the  willingness 
with  which  she  gave  attention  to  my  every  little  sorrow  and 
trouble.  I  can  see  her  face  beaming  now.  I  never  saw  her 
without  a  smile,  and  so,  Doctor,  when  the  awful  verdict  was 
reached  in  my  case.  I  spent  just  two  days  and  two  nights  in 
despondency  and  despair.  Then  I  decided  that  my  last  years 
should  be  my  best  and  I  have  simply  been  impersonating  the 
memories  which  I  held  of  this  kind-faced  old  lady  of  my 
childhood  days,  and  I  only  trust  that  I  have  been  successful  in 
my  effort  — that  in  a  measure  I  have  succeeded  in  living  over 
again  to  the  world  her  life  as  she  so  beautifully  lived  it  forty 
years  ago." 

And  that  is  just  what  I  mean  by  acting  — impersonating  —  on 
the  part  of  neurasthenics.  Let  the  neurotic  patient  bring  forth 
from  the  halls  of  memory,  or  from  the  creative  realms  of  his 
own  imagination,  the  picture  of  the  character  he  should  be,  and 
would  like  to  be.  and  then  calmly  and  coolly  take  up  the  program 
of  acting  it  out  day  by  day.  and  ere  long,  sooner  or  later,  he 
will  in  real  experience  actually  achieve  more  or  less  of  the 
desirable  qualities  which  pertain  to  the  character  he  has  chosen. 


THE  REST  OR  PLAY  CURE  467 

SUMMARY   OF   THE   CHAPTER 

1.  The  old  fashioned  "  rest  cure  "  for  nervousness  consisted 
in  complete  rest,  isolation,  over-feeding,  massage,  etc.,  and  is 
useful  only  in  certain  severe  and  select  cases. 

2.  The  more  modern  M  rest  cure  "  avoids  isolation  and  over- 
feeding, substituting  therefor  physical  remedies,  together  with 
recreation  and  play. 

3.  The  weekly  rest  day  —  diversion  from  week-day  employ- 
ment—  as  well  as  a  mid-week  half  holiday  are  all  highly  use- 
ful in  the  cure  of  neurotic  workers. 

4.  Recent  methods  of  precision  demonstrate  that  a  rest  day 
or  a  day  of  change  in  one's  work,  definitely  increases  the  nerve 
tone  and  elevates  the  vital  resistance. 

5.  The  "  play  cure  "  —  free-hearted,  spontaneous,  and  enthu- 
siastic outdoor  recreation  —  yields  unexpected  results  in  the 
treatment  of  the  nervous  states. 

6.  The  "  play  cure  "  is  most  highly  efficient  when  employed 
in  proper  and  alternate  cycles  with  the  "  work  cure."^  It  is  the 
"  work-play  "  regime  that  constitutes  the  real  "  cure." 

7.  Persistent  and  progressive  efforts  at  both  outdoor  work 
and  outdoor  play  are  inevitably  followed  by  beneficient  results. 

8.  While  certain  "  vicious  circles  "  operate  to  make  neurotics 
worse,  there  are  also  "  benevolent  circles  "  in  which  faith  and 
hope  and  joy,  combined  with  work  and  play,  operate  to  hasten 
the  patient's  recovery. 

9.  Art  and  play  have  the  same  functions  in  mental  therapeu- 
tics, that  is  to  relax,  relieve  tension,  to  divert,  rest  and  refresh 
the  mind  and  nerves. 

10.  Play  in  contrast  with  work,  embraces  those  whole-souled 
and  unhampered  activities  of  mind  and  body  which  have  no 
other  object  than  the  satisfaction  of  unfettered  self-expression. 

11.  Even  play  has  its  "rules  of  the  game,"  and  "scrappy" 
plays  are  those  lawless  activities  indulged  in  by  the  young  when 
their  instincts  are  not  organized  and  not  better  directed. 

12.  "  Gambling  "  and  other  vicious  forms  of  diversion  repre- 
sent the  "  scrappy  "  play  of  the  adult  whose  diversions  have 
become  sordid  and  whose  recreation  is  misdirected. 

13.  Play  affords  almost  unlimited  opportunities  for  sugges- 
tion and  impersonation,  and  impersonating  is  one  of  the  secrets 
of  the  cure  of  nervousness. 

14.  A  neurasthenic  actor  impersonated  a  character  of  sound 
nerves  and  self-controlled  demeanor  for  a  single  season  and 
found  himself  practically  cured. 

t;.  Nervous  patients  should  cultivate  the  simple  art  of  being 
good  natured.  Practice  contentment  while  cheerfully  playing 
your  role  of  life. 


468 


WORRY  AND  NERVOUSNESS 


16.  Cultivate  smiling  —  it  is  the  unmistakable  badge  of  good 
nature  and  good  humor,  and  these  are  powerful  remedies  in 
nervousness. 

17.  Good  humor  is  the  highest  attainment  of  good  manners. 
A  grouch  pushes  you  down  hill  but  good  etiquette  helps  you 
in  the  upward  climb. 

18.  When  you  play  be  happy,  "  cut  loose,"  throw  your  whole 
soul  into  the  enjoyment  of  your  recreation. 


CHAPTER  XXXV 

THE  WORK  OR  OCCUPATION  CURE 

IDLE  neurasthenics  must  be  set  to  work  at  some  regular  task 
of  employment  —  they  must  be  occupied  with  some  sort  of 
productive  effort  —  which  will  sufficiently  occupy  the  intellect 
to  enable  them  to  "  keep  their  minds  off  their  own  thoughts  and 
feelings."  "  Get  busy,"  is  the  therapeutic  slogan  for  neurotics; 
only,  they  must  not  overdo  the  "  work  cure,"  they  must  adjust 
their  occupational  activities  to  their  strength,  experience,  taste, 
and  temperament;  and  when  this  can  be  done,  immediate  im- 
provement will  almost  invariably  reward  the  practice  of  occu- 
pational therapeutics. 

THE    CURATIVE    VALUE    OF    EXERTION 

Enthusiastic,  whole-hearted  work  —  intelligent  exertion  in 
some  line  of  productive  effort  —  some  useful  employment  which 
will  reward  the  toiler  and  add  something  to  the  value  of  the 
sum  of  the  world's  work,  will  prove  to  be  the  therapeutic  salva- 
tion of  the  average  neurotic.  When  we  can  find  a  man  who 
is  adapted  to  his  work  and  his  work  is  within  his  range,  then 
it  is  that  work  comes  well-nigh  being  play.  If  one's  mental  or 
physical  work  could  be  carried  forward  minus  all  of  this 
nervous  tension  and  anxious  stress,  it  would  be  found  that 
our  daily  exertions  are  not  one-half  as  wearing  and  tearing  as 
we  commonly  imagine.  (Fig.  20.)  One  of  the  great  causes 
of  over-fatigue  and  subsequent  nervous  breakdown  is  dissatis- 
faction and  discontent  with  one's  daily  task.  This  is  shown  by 
the  fact  that  when  one's  interest  and  enthusiasm  are  enlisted  and 
aroused,  it  is  possible  to  carry  on  arduous  tasks  involving  long 
hours  and  sometimes  in  violation  of  every  known  principle  of 
hygiene,  possibly  involving  even  conscious  suffering,  and, 
because  of  the  keen  mental  interest  in  the  effort,  all  this  is 

469 


470  WORRY  AND  NERVOUSNESS 

accomplished  without  observing  any  apparent  undesirable  results 
on  either  the  general  health  or  that  of  the  nervous  system.  In 
fact,  there  are  many  nervous  workers  who  complain  of  their 
hard  work  and  their  long  hours  in  utter  ignorance  of  the  fact 
that  if  their  work  were  made  easier  and  their  hours  shorter, 
unless  they  immediately  acquired  other  and  more  preoccupying 
pursuits,  they  would  soon  discover  that  these  changes  instead  of 
being  for  the  better,  as  regards  the  health  of  their  nervous  sys- 
tems, were  decidedly  for  the  worse. 

One  of  the  great  institutional  needs  of  this  generation  is 
sanitariums  where,  in  addition  to  all  of  the  ordinarily  em- 
ployed physical  methods  —  in  addition  to  a  good  psychothera- 
peutic regime  —  the  patient  shall  be  set  to  work  in  the  fields, 
in  the  shop,  and  at  the  arts  and  crafts.  I  mean  real  work  — 
not  purposeless  gymnasium  stunts.  This  work  should  be  per- 
formed under  competent  instructors  so  that  the  products  of 
their  therapeutic  efforts  would  be  salable,  and  the  fact  that 
they  were  engaged  in  making  something  that  could  be  sold  in 
the  open  market,  and,  the  further  fact,  that  this  money  would 
be  paid  to  them  personally,  would  constitute  the  chief  charm 
and  remedial  value  of  such  "  work  cures." 

WORK  AS  A  WORRY  CURE 

Work  is  the  one  great  cure  for  worry,  and  if  the  neurasthenic 
can  get  started  at  some  task  without  making  the  disheartening 
mistake  of  overdoing  at  first,  then  after  a  few  experiences  with 
the  work-rest  cycle  —  after  a  few  tastes  of  the  blessed  reward 
that  inevitably  follows  interested  toil  —  he  will  fall  in  love 
with  employment  and  will  rejoice  in  his  new  found  deliverance 
from  inaction  and  ennui. 

Have  you  ever  gone  among  the  unemployed  at  the  time  of  a 
strike  — when  thousands  of  men  were  suddenly  thrown  out 
of  employment?  If  you  have  and  looked  at  things  from  the 
doctor's  standpoint,  you  have  watched  men  grow  restless  and 
sick.  You  have  observed  them  chafing  and  suffering  under  the 
gall  of  sheer  inaction.  I  have  cured  any  number  of  nervous 
and  restless  people  by  setting  them  to  work.  There  is  nothing 
like  work  for  the  blues,  for  those  neurotic  idlers  whose  entire 


Gardening  for  the  Nerves 
FIG.  20.  PRACTICING  THE  ;  WORK  CURE 


THE  WORK  OR  OCCUPATION  CURE  471 

time  is  spent  in  self-contemplation.  There  are  a  lot  of  well- 
to-do  women  who  could  do  much  toward  improving  both  their 
health  and  their  happiness  if  they  would  enlist  in  club  work, 
turn  suffragette,  or  in  any  other  way  occupy  their  energies  in 
some  line  of  endeavor  which  would  relieve  them  from  the  ter- 
rible burden  of  that  never-ending  thought  of  self  and  self- 
pleasure. 

The  thinking  power  and  possibilities  of  the  human  brain 
which  should  ever  be  directed  out  into  new  realms  of  creative 
labor,  into  new  paths  and  new  fields,  sooner  or  later  comes  to 
circle  round  and  round  within  itself  until  the  brain  becomes 
dizzy  and  the  mind  intoxicated  with  its  own  inherent  self- 
thought  and  self-pity. 

THE    IDLE    RICH 

Of  all  classes  of  neurotics,  the  most  difficult  to  treat  and  cure 
are  the  neurasthenic,  hysteric,  and  dipsomaniac  who  belong  to 
the  idle  wealthy  classes.  I  have  under  my  care  at  the  present 
time  a  young  man  of  a  well-to-do  family  who  has  been  "  put 
through  college,"  during  the  course  of  which  he  acquired  the 
drink  habit,  and  now  his  father,  a  successful  business  man,  has 
become  utterly  disgusted  with  this,  his  eldest  son,  and  refuses 
to  give  him  money  to  start  in  business,  and  so  the  young  fel- 
low has  started  out  on  a  program  of  "  killing  time."  In  this 
he  is  fairly  successful  and  is  also  accomplishing  something 
toward  killing  off  himself,  as  he  is  becoming  a  first-class  nervous 
wreck,  a  confirmed  periodical  drinker.  Both  his  mother  and 
eldest  sister  never  cease  to  importune  me  to  do  something  for 
their  son  and  brother,  and  I  am  forced  again  and  again  to  tell 
them  that  they  are  unaware  of  the  difficulties  of  the  task  they 
are  asking  me  to  perform.  To  cure  this  boy  would  mean  to 
create  a  new  relationship  in  his  family  —  a  new  relationship 
between  himself  and  his  father.  It  would  further  mean  that 
this  boy  must  be  taught  to  work,  to  earn  his  own  living,  it 
would  mean  that  his  social  viewpoint  of  life  must  be  entirely 
changed,  that  he  must  recognize  the  necessity  of  abandoning  his 
parasitic  career  and  become  one  of  the  world's  workers  —  a 
bona-fide   producer.     It  would   further  mean  that  he  must  be 


472  WORRY  AND  NERVOUSNESS 

educated  out  of  his  self-pity,  and  his  ideas  of  self-importance  — 
exaggerated  ego.  It  would  mean  that  he  must  be  given  an 
interest  in  life  and  trained  into  the  joys  of  well-earned  rest  — 
that  satisfaction  that  accompanies  the  rest  which  follows  pro- 
ductive toil,  whether  it  be  of  the  mental  or  physical  sort. 

And  so  we  are  constantly  besought  by  people  who  want  us 
to  cure  their  neurasthenia  or  remove  their  ennui,  much  of 
which  is  due  to  idleness,  indulgence,  and  inactivity.  It  is  certain 
that  such  neurasthenics  as  these  are  not  in  need  of  the  conven- 
tional "  rest  cure."  It  is  the  "  work  cure  "  in  its  largest  sense 
that  is  needed  to  bring  about  their  relief  from  the  corroding 
rust  of  idleness,  indolence,  worry,  and  ennui.  The  physician 
who  sees  many  nervous  patients  comes  to  look  upon  both  wealth 
and  poverty  as  a  curse  to  the  race.  The  iron  heel  of  poverty 
grinds  down  the  poor  until  their  nerves  are  worn  to  a  frazzle, 
while  the  luxuries  of  wealth  lead  up  to  that  idleness  and  ennui 
from    which    it    is    almost    impossible    to    effect    a    therapeutic 


INDUSTRIAL    SLAVERY 

While  we  can  have  little  admiration  for  the  type  of  idle 
human  being  who  lives  on  breadfruit,  cocoanuts,  and  bananas 
off  on  some  tropical  isle,  while  such  a  life  is  hardly  conducive 
to  the  development  of  character  and  the  acquirement  of  strong 
mentality,  nevertheless,  we  must  recognize,  on  the  other  side, 
that  the  tension  of  modern  industry  with  its  "  speeding  up  " 
tendency  is  exceedingly  ruinous  to  the  nervous  system.  Es- 
pecially are  the  brain  and  nerve  centers  of  more  recent  train- 
ing and  education  over-taxed  and  over-worked.  Normal  work 
—  reasonable  hardship  and  average  responsibility  —  should  be 
borne  by  the  average  human  nervous  system  without  evi- 
dencing any  special  stress  or  strain ;  but  the  modern  pressure 
in  many  lines  of  industry  partakes  so  largely  of  the  nature 
of  "  being  driven,"  that  —  to  the  mind  and  nervous  system  — 
these  strenuous  efforts  come  to  be  regarded  as  a  form  of  occu- 
pational slavery,  and  it  is  the  resultant  restlessness  and  re- 
sentment that  is  responsible  for  so  much  of  this  premature 
breaking  down  of  the  hereditarily  predisposed  nervous  system. 


THE  WORK  OR  OCCUPATION  CURE  473 

On  the  other  hand,  when  there  is  a  keen  personal  interest  in 
one's  work,  when  there  is  a  worthy  prize  to  obtain  or  desirable 
goal  to  reach,  then  the  patient  is  able  to  stand  an  extra  amount 
of  work  without  a  breakdown.  It  makes  little  difference 
whether  it  is  head  work  or  hand  work ;  so  far  as  that  is  con- 
cerned, he  is  equally  exposed  to  the  danger  of  nervous  break- 
down, and  is  equally  lightened  by  joy  and  keen  personal 
satisfaction. 

The  same  amount  of  exertion  and  stress  and  strain  that  will 
cause  a  nervous  breakdown  in  a  patient  working  for  a  meager 
salary,  I  have  observed,  will  not  result  in  the  same  disaster  when 
the  worker  is  better  paid.  When  the  reward  —  the  wage  —  is 
adequate  and  attractive  the  neurotic  worker  bears  the  strain  of 
effort  much  more  gracefully  and  for  a  longer  time.  While 
money  is  in  no  wise  a  measure  of  the  value  of  one's  work, 
nevertheless,  as  long  as  it  stands  as  the  medium  of  exchange 
in  this  world,  it  seems  to  have  a  wonderful  tonic  effect  upon 
the  wage  earner  to  have  his  salary  increased.  At  least,  I  have 
found  out  that  when  I  try  to  get  neurasthenics  to  work  just 
for  the  sake  of  exercise.  I  have  little  success  in  arousing  their 
enthusiasm.  They  do  not  take  kindly  to  dumb-bells,  wands, 
and  chest  weights.  The  gymnasium  treadmill  is  a  figurative 
one  as  well  as  a  literal  one.  but  if  I  can  get  this  same  neuras- 
thenic patient  sanely  interested  in  lucrative  work,  he  sometimes 
forgets  the  exertion  required  in  the  efforts  he  puts  forth,  while 
he  is  cheered  on  in  anticipation  of  the  reward  he  is  to  receive. 

A    GOOD    JOB   DEFINED 

There  are  a  number  of  things  which  are  essential  to  a  good 
job  from  the  standpoint  of  the  "  work  cure."  I  think  Dr. 
Cabot  has  given  us  about  the  best  definition  of  the  essentials 
of  employment  from  the  standpoint  of  curing  nervousness. 
He  savs  that  a  good  job  should  have  or  provide  the  following 
seven  essentials. 

(i)  Difficulty  and  crudeness  enough  to  call  out  our  latent  powers 
of  mastery.  (2)  Variety  so  balanced  by  monotony  as  to  suit  the 
individual's  needs.  (3)  A  boss.  (4)  A  chance  to  achieve,  to  build 
something  and  to  recognize  what  we  have  done.     (5)   A  title  and  a 


474  WORRY  AND  NERVOUSNESS 

place  which  is  ours.  (6)  Connection  with  some  institution,  some 
firm  or  some  cause,  which  we  can  loyally  serve.  (7)  Honorable 
and  pleasant  relation  with  our  comrades  in  work.  Fulfill  these  con- 
ditions and  work  is  one  of  the  best  things  in  life.  Let  me  describe 
them  more  fully. 

We  want  a  chance  to  subdue.  Boys  like  to  go  stamping  through 
the  woods  in  thick-soled  boots.  They  like  to  crush  the  sticks  in 
their  path  and  to  jerk  off  the  branches  that  get  in  their  way.  If 
there  is  need  to  clear  a  path,  so  much  the  better ;  the  pioneer's 
instinct  is  the  more  strongly  aroused.  For  there  is  in  most  of  us 
an  ancient  hunger  to  subdue  the  chances  which  we  meet,  to  tame 
what  is  wild.  As  another's  anger  calls  out  ours,  so  the  stubbornness 
of  nature  rouses  our  determination  to  subdue  it.  We  want  to  en- 
counter the  rough  and  crude.  Before  the  commercial  age,  war, 
hunting,  and  agriculture  gave  us  this  foil.  We  want  it  still,  and 
for  the  lack  of  it  often  find  our  work  too  soft. 

We  want  both  monotony  and  variety.  The  monotony  of  work  is 
perhaps  the  quality  of  which  we  most  often  complain  —  often  justi- 
fiably. Yet  monotony  is  really  demanded  by  almost  everyone. 
Even  children  cry  for  it,  though  in  doses  smaller  than  those  that 
suit  their  elders.  Your  secretary  does  not  like  her  work  if  you  put 
more  than  her  regular  portion  of  variety  into  it.  She  does  not 
want  to  be  constantly  undertaking  new  tasks,  adapting  herself  to 
new  situations.  She  wants  some  regularity  in  her  traveling,  some 
plain  stretches  in  which  she  can  get  up  speed  and  feel  quantity  of 
accomplishment;  that  is,  she  wants  a  reasonable  amount  of 
monotony. 

We  want  a  boss,  especially  in  heavy  or  monotonous  work.  Most 
monotonous  work  is  of  the  sort  that  is  cut  out  and  supplied  ready 
to  hand.  This  implies  that  someone  else  plans  and  directs  it.  If 
we  are  to  do  the  pulling,  someone  else  should  hold  the  reins.  When 
I  am  digging  my  wife's  garden  beds,  I  want  her  to  specify  where 
they  shall  go.  We  all  want  a  master  of  some  kind,  and  most  of 
us  want  a  master  in  human  shape.  The  more  manual  our  work 
is,  the  more  we  want  him.  Boatmen  poling  a  scow  through  a 
creek  need  someone  to  steer  and  to  tell  them  which  should  push 
harder  as  they  turn  the  bend  of  the  stream. 

We  want  to  see  the  product  of  our  work.  The  bridge  we  plan, 
the  house  we  build,  the  shoes  we  cobble,  help  us  to  get  before  our- 


THE  WORK  OR  OCCUPATION  CURE  475 

selves  and  so  to  realize  more  than  a  moment's  worth  of  life  and 
effort.  The  impermanence  of  each  instant's  thought,  transience  of 
every  flush  of  effort,  tends  to  make  our  lives  seem  shadowy  even 
to  ourselves. 

We  want  a  handle  to  our  name.  Every  one  has  a  right  to  the  dis- 
tinction which  titles  of  nobility  are  meant  to  give,  but  it  is  from 
our  work  that  we  should  get  them.  The  grocer,  the  trapper,  the 
night-watchman,  the  cook,  is  a  person  fit  to  be  recognized,  both  by 
his  own  timid  self  and  by  the  rest  of  the  world.  In  time  the  title 
of  our  job  comes  to  stand  for  us,  to  enlarge  our  personality  and  to 
give  us  permanence.  Thus  it  supplements  the  standing  which  is 
given  us  by  our  product.  To  "hold  down  a  job"  gives  us  a  place 
in  the  world,  something  approaching  the  home  for  which  in  some 
form  or  other  everyone  longs.  "Have  you  any  place  for  me?" 
we  ask  with  eagerness ;  for  until  we  find  "  a  place  "  we  are  tramps, 
men  without  a  country. 

Loyalty  to  association.  And  though  our  work  and  our  science 
are  symbolic,  as  I  believe,  of  an  eternal  and  glorious  destiny,  they 
are  literally  very  inglorious  and  insignificant.  Only  their  intention, 
only  the  vision  that  creates  and  sustains  them  is  great.  Our  work 
is  the  best  we  know,  and  in  it  as  in  a  ship  we  have  embarked  with 
our  treasures ;  but  still  it  is  human-made,  and  bears  the  impress 
of  our  limitations.  Work  seen  literally  is  a  misfit,  and  now  and 
then  our  tired  eyes  see  it  so;  then  it  looks  like  a  curse.  We  should 
spurn  it  but  for  a  voice  within  us  which  rebukes  literalism  and  calls 
it  a  lie.     That  voice  is  loyalty. 

Loyalty  is  a  force  that  holds  a  man  to  his  job  even  in  the  mo- 
ments when  he  hates  it  and  sees  no  significance  in  it.  When  this 
kind  of  blindness  falls  upon  us  loyalty  supplies  a  new  method  of 
guidance  towards  the  substance  of  things  not  seen.  Like  all  faith, 
it  holds  to  the  visible  framework  of  daily  labor  by  grim  or  by  smil- 
ing determination.  It  bids  us  to  be  prompt  at  the  office,  to  answer 
all  letters  at  once,  to  look  as  brisk  and  interested  as  we  can,  till 
the  mood  passes  and  the  familiar  objects  and  occupations  resume 
their  halos. 

We  want  congeniality  with  our  fellow-workmen.  One  of  the 
few  non-physical  "  points  "  which  people  have  already  learned  to  look 
for  in  selecting  work  is  the  temper  and  character  of  the  "boss." 
Men,  and  especially  women,  care  almost  as  much  about  this  as 
about  the  hours  and  wages  of  the  job.    Young  physicians  will  work 


476  WORRY  AXD  NERVOUSNESS 

in  a  laboratory  at  starvation  wages  for  the  sake  of  being  near  a 
great  teacher,  even  though  he  rarely  notices  them.  The  congeniality 
of  fellow-workmen  is  almost  as  important  as  the  temper  of  the  boss. 
Two  unfriendly  stenographers  in  a  single  room  will  often  give  up 
their  work  and  take  lower  wages  somewhere  else  in  order  to  escape 
each  other. 

THE    DELIVERANCE   OF    WORK 

As  an  instance  of  the  saving  grace  of  employment  and  the 
curative  power  of  work,  let  me  cite  the  following:  Miss  D. 
was  upward  of  thirty  years  of  age,  she  was  well-educated,  had 
traveled  much,  and  had  been  more  or  less  of  a  neurasthenic  all 
her  life.  In  her  case,  matters  had  gone  from  bad  to  worse 
until  she  had  unfortunately  been  led  into  certain  highly  repre- 
hensible practices;  and  so  after  religion  and  everything  else 
had  failed,  even  in  the  face  of  a  threatened  nervous  collapse, 
we  advised  this  patient  that  the  only  hope  of  recovery  lay  along 
the  lines  of  the  "  work  cure." 

I  never  became  alarmed  with  reference  to  the  final  recovery 
of  this  patient  until  there  was  a  threatened  loss  of  interest  in 
work  and  then  I  became  thoroughly  aroused.  This  danger  I 
discerned  in  a  letter  brought  by  a  messenger  to  my  office  one 
morning,  an  extract  from  which  I  quote : 

Dear  Dr.:  As  usual  I  am  lying  here  awake  at  three  A.  M.  I 
slept  until  nearly  three  o'clock,  probably  about  four  and  a  half 
hours  from  the  time  I  fell  asleep.  Xow  is  the  awfulest  time  of 
my  night  and  I  am  writing  to  tell  you  something  which  I  did  not 
dwell  on  yesterday  and  which  is  of  vital  importance,  the  loss  of 
interest  in  my  work. 

Thus  far  I  have  managed  to  conduct  my  work  with  apparent 
enthusiasm,  but  I  am  losing  ambition.  I  can't  become  absorbed  in 
the  necessary  preparation  for  some  new  duties.  I  am  so  terribly 
fatigued  and  depressed.  My  mind  is  possessed  with  the  thought  of 
loss  and  disappointment.  But  the  loss  of  interest  in  my  work 
alarms  me.  What  can  rescue  me  from  sorrow  and  corroding  worry, 
futile  regrets  and  unutterable  longings  impossible  to  satisfy,  if  it 
is  not  work?  The  person  who  truly  loves  some  work  is  absorbed 
by  it,  and  has  the  energy  to  do  it  in  his  best  manner,  always  has 
something  to  keep  him  sane.  The  work  I  am  doing  now  is  not 
holding  me   as  it  should.     I  need  work  that  could  absorb   me.     I 


THE  WORK  OR  OCCUPATION  CURE  477 

need  surroundings  that  would  tranquilize  my  spirits.  I  need  the 
constant  influence  of  true  Christians.  I  need  to  forget  what  is  un- 
wholesome. My  spirit  is  broken.  Every  day  finds  me  less  prepared 
to  do  my  share  of  the  world's  work,  the  greater  tragedy  because 
the  world  needs  faithful  work  and  I  need  the  satisfaction  which 
comes  from  giving  the  world  what  it  needs.  Oh,  for  a  position  in 
some  quiet  beautiful  spot  where  I  could  have  fresh  air  and  sun- 
shine and  Christian  influence  of  the  right  sort. 

Work,  work,  a  work  to  absorb  my  mind,  my  heart!  To  make 
me  forget  what  has  never  brought  anything  but  loss  and  sorrow. 
Oh,  to  know  what  to  do !  I  am  fatigued  beyond  all  reason,  more 
tired  in  the  morning  than  in  the  evening.  Now,  however,  I  feel  tired 
all  the  time.  I  am  going  to  close.  Perhaps  this  effort  to  show  what 
my  attitude  toward  the  importance  of  true  interest  in  sane  work 
is.  will  give  you  another  useful  glimpse  into  my  character.  But 
remember,  at  present  work  fails  to  help  and  I  shirk  it. 

And  this  patient  was  by  no  means  mistaken.  Her  salvation 
from  a  medical  standpoint,  was  all  bound  up  in  wrork.  In  this 
case  we  were  able  to  persuade  the  patient  to  keep  at  work, 
to  fight  through  the  battle  and  win  the  victory  by  sticking  to 
her  task.  Wearing  as  it  was  on  her  nerves,  to  continue  working 
in  such  a  state  of  mind  and  body,  nevertheless,  the  influence 
of  this  wear  and  tear  was  nothing  compared  to  the  sorrow  and 
regret  —  the  sense  of  defeat  —  that  would  have  followed  the 
giving  up  of  work. 

THE    WALKING    CURE 

Walking  is  a  great  aid  in  the  management  of  nervousness. 
It  improves  the  circulation,  not  to  mention  the  digestion.  It 
helps  the  neurasthenic  to  sweep  away  his  mental  cobwebs.  I 
have  found  walking  especially  helpful  in  case  it  can  be  car- 
ried on  in  groups  —  in  congenial  company;  but  in  the  lesser 
forms  of  neurasthenia,  even  the  lone  cross  country  walk  is 
found  diverting,  if  it  can  be  indulged  in  in  the  spirit  of  James 
Whitcomb  Riley's  "  A  Country  Pathway." 

I  come  upon  it  suddenly,  alone  — 

A  little  pathway  winding  in  the  weeds 
That  fringe  the  roadside ;  and  with  dreams  my  own, 

I  wander  as  it  leads. 


478  WORRY  AND  NERVOUSNESS 

Full  wistfully  along  the  slender  way. 
Through  summer  tan  of  freckled  shade  and  shine, 

I  take  the  path  that  leads  me  as  it  may  — 
Its  every  choice  is  mine. 

And  though  it  needs  must  lure  me  mile  on  mile 

Out  of  the  public  highway,  still  I  go, 
My  thoughts,  far  in  advance  in  Indian-file, 

Allure  me  even  so. 

The  daily  ride  to  and  from  work  may  in  many  cases  be 
changed  with  profit  to  a  daily  walk.  There  are  few  men  and 
women  who  are  leaving  home  in  the  morning  for  office,  or  in 
the  evening  from  the  office  for  home,  who  could  not  do  twenty 
to  forty  city  blocks  with  the  utmost  ease  and  with  the  use  of 
very  little  more  time  than  is  consumed  in  waiting  on  the  cor- 
ner for  street  cars,  and  in  the  slow  journey  of  the  trolley 
through   trafHc-crowded   streets. 

SUMMARY  OF  THE  CHAPTER 

1.  Every  neurasthenic  must  have  sufficient  interesting  and 
productive  work  to  enable  him  to  keep  his  mind  off  his  own 
thoughts  and  feelings. 

2.  Enthusiastic,  whole-hearted  work  —  intelligent  exertion  in 
some  useful  and  interesting  line  —  will  prove  the  therapeutic 
salvation  of  the  average  neurasthenic. 

3.  A  keen  interest  coupled  with  spontaneous  enthusiasm  does 
much  to  overcome  the  weariness  of  drudgery  and  the  fatigue 
of  routine  labor. 

4.  While  many  neurotics  complain  of  their  arduous  tasks, 
nevertheless,  even  taxing  effort  is  better  for  their  nerves  than 
inaction  and  idleness. 

5.  One  of  the  great  institutional  needs  of  this  day  is  a  sani- 
tarium where,  in  addition  to  physiological  therapeutics  and 
psychotherapy,  the  patients  shall  be  employed  in  productive  man- 
ual labor. 

6.  Work  is  the  one  great  cure  for  worry.  The  sweet  deliver- 
ance from  inaction  and  ennui  is  to  fall  in  love  with  useful 
labor. 

7.  When  the  creative  power  of  the  human  mind  is  not  utilized 
in  productive  fields,  it  circles  round  and  round  within  itself  — 
forms  mental  short  circuits. 

8.  Of  all  classes  of  neurotics  the  most  difficult  to  cure  are 
the  neurasthenic,  hysteric,  and  dipsomaniacs  who  belong  to  the 
idle  wealthy  classes. 


THE  WORK  OR  OCCUPATION  CURE  479 

9.  While  pleasant  and  useful  work  is  a  part  of  the  cure  for 
many  forms  of  nervousness;  on  the  other  hand,  industrial  slav- 
ery must  not  be  regarded  in  such  a  favorable  light. 

10.  The  stress  and  strain  that  produces  nervous  collapse  in 
the  underpaid  worker  is  borne  with  comparative  ease  when  the 
salary  is  large  and  the  reward  attractive. 

11.  A  good  job  is  defined  as  employment  which  affords  oppor- 
tunity for  conquest,  provides  variety,  together  with  pleasant 
associations,  and  promises  a  satisfactory  reward. 

12.  Neurasthenics  should  be  given  something  to  subdue  — 
in  addition  to,  and  separate  and  apart  from  the  conquest  of  their 
nerves. 

13.  It  is  good  for  neurotics  to  go  out  in  the  woods,  provide 
food  with  their  own  hands,  and  cook  it  on  the  end  of  a  stick. 

14.  In  the  practice  of  the  "  work  cure  "  for  neurasthenia,  em- 
ployment must  be  provided  which  will  afford  both  monotony  and 
variety. 

15.  Neurasthenics  need  a  boss.  They  need  to  have  some  one 
everlastingly  on  the  job  of  directing  their  cure. 

16.  Nervous  patients  must  be  able  to  see  the  results  of  their 
efforts  —  they  must  feel  that  they  are  "  holding  down  a  job." 

17.  Loyalty  to  human  associations  and  congeniality  with  one's 
fellows  are  both  exceedingly  helpful  in  overcoming  the  nervous 
states. 

18.  Work  —  even  at  the  cost  of  severe  nervous  strain  — 
has  delivered  many  a  patient  from  a  life  of  nervous  semi- 
invalidism. 

19.  The  "  walking  cure  "  is  a  valuable  aid  in  the  treatment 
of  neurasthenics  of  sedentary  habits. 


CHAPTER  XXXVI 
THE  SOCIAL  SERVICE  CURE 

IX  OUR  study  of  the  psychology  of  work  and  play  and  rec- 
reation, we  endeavored  to  show  the  reader  that  it  was 
necessary  for  nervous  patients  to  develop  some  absorbing  in- 
terest outside  of  themselves  —  to  get  their  minds  off  themselves 
and  onto  something  else  —  and  there  is  nothing  in  all  the  wide- 
world  upon  which  such  nervous  patients  may  place  their  minds 
with  such  safety  and  satisfaction  as  their  own  fellow-men. 
There  is  nothing  with  which  they  may  occupy  their  attention 
which  can  compare  with  *'  social  service,"  that  interesting  and 
fascinating  labor  in  behalf  of  one's  fellow-beings.  Unselfish 
work  for  others  is  the  best  known  means  of  therapeutically 
occupying  and  diverting  the  mind  of  the  nervous  patient. 

TOLERANCE   AND   INDULGENCE 

Nervous  people  must  train  themselves  to  become  more  tol- 
erant of  other  people"s  opinions.  It  helps  us  in  overcoming  our 
own  petty  whims  if  we  can  train  ourselves  to  become  indulgent 
of  the  whimsical  conduct  of  our  friends  and  fellow-workers. 
Intolerance  lies  at  the  root  of  much  of  the  domestic,  social, 
and  commercial  friction  which  only  serves  to  add  to  the  worries 
and  anxieties  of  so  many  neurotic  sufferers.  If  we  could  only 
be  more  charitable  and  tolerant  toward  our  associates,  we  would 
not  be  so  annoyed  and  put  out  by  those  little  features  of  their 
lives  which  are  at  variance  with  our  standards  and  tastes. 
When  our  friends  annoy  us,  we  should  be  wise  enough  frankly 
to  forgive  them,  if  for  no  other  reason  than  to  preserve  our 
own  peace  and  tranquility  of  mind.  The  one  who  bears  a  grudge 
or  carries  a  grievance  is  the  one  who  is  most  hampered  and 
injured  by  this  uncharitable  and  unsocial  attitude. 

Of  course,  we  have  to  be  infinitely  patient  with  these  fretful, 

480 


THE  SOCIAL  SERVICE  CURE  481 

nervous  individuals  in  the  early  stages  of  their  treatment.  It 
does  little  good  to  scold  or  reproach  them.  We  have  rather 
to  encourage  and  cheer  them  on,  recognizing  that  they  are  not 
guilty  of  deliberate,  willful  ill  humor.  I  think  I  sometimes 
look  upon  these  unruly  nervous  patients  with  their  uncon- 
trolled temper  and  emotions,  as  a  mother  would  upon  a  tired, 
irritable,  and  half  sick  child ;  and  I  am  quite  sure  that  this 
wise  and  loving  mother  would  probably  account  for  the  child's 
temper  and  bad  humor  by  explaining  that  it  had  had  insufficient 
sleep  and  then  quietly  undress  and  put  the  little  fellow  to  bed. 

THE   CHEERING-UP   BUSINESS 

If  you  want  to  get  over  the  blues  in  a  hurry,  you  just  get 
right  down  to  work  and  enlist  in  the  "  cheering-up  "  business. 
Begin  the  moment  you  are  up  and  dressed  in  the  morning,  and 
from  that  moment  until  you  are  tucked  away  in  bed  at  night, 
make  it  the  one  object  of  your  existence  to  cheer  up  anybody 
and  everybody  you  meet.  Blow  into  the  dining-room  at  break- 
fast time  with  a  pleasant  and  hearty  greeting  for  everyone.  Of 
course,  it  may  be  a  severe  shock  to  your  loved  ones  to  note 
this  sudden  change  in  demeanor,  but  be  assured  they  will  sur- 
vive the  shock,  and  after  a  few  mornings  they  will  grow  quite 
accustomed  to  your  wearing  a  pleasant  smile  and  handing  out 
cheery  "good  mornings";  and  then,  if  you  are  of  the  prole- 
tariats and  ride  down  town  on  the  street  car,  when  the  back 
platform  gets  over-crowded  and  the  conductor  grouchy,  keep 
everybody  cheered  up;  try  and  accost  the  conductor  when  you 
board  the  car  in  such  a  way  that  he  will  absorb  enough  good 
cheer  from  you  to  last  him  until  he  gets  down  town.  Give  the 
stenographer  and  bookkeeper  at  the  office  a  refreshing  surprise 
by  the  cheery  manner  in  which  you  come  in,  or,  perchance,  if 
you  are  a  housewife,  let  the  children  and  servants  be  astonished 
at  your  unexpected  good  cheer;  and,  whether  you  are  rich  or 
poor,  whether  you  are  employee  or  employer,  remember  that  this 
good  humor  will  help  to  cheer  the  world  along  and  to  cure  your 
neurasthenia,  remedy  your  grouch,  relieve  your  aches  and  pains, 
comfort  your  sorrows.  Just  play  the  role  of  the  social  hypo- 
crite and  make  every  one  believe  you  are  the  happiest  man  or 


482  WORRY  AND  NERVOUSNESS 

the  happiest  woman  in  the  world.  Be  like  Polly  Ann  of  the 
Glad  Book  fame,  and  see  if  you  cannot  find  a  few  things  in 
your  life  worth  being  thankful  for. 

Good  cheer,  laughter,  and  light-heartedness  seems  to  be  of 
real  value  in  the  treatment  of  the  nervous  states;  they  seem 
to  relieve  the  attention  spasm,  they  serve  the  purpose  of  get- 
ting your  mind  off  yourself  for  a  moment,  and  it  is  easier, 
after  a  mental  recess  of  this  sort,  to  get  the  mind  started 
along  more  wholesome  and  helpful  lines. 

Cultivate  the  society  of  children  and  good  humored  adults. 
I  have  advised  many  of  my  lonely,  selfish,  and  nervous  patients 
to  adopt  a  bright-faced  baby  into  the  home.  They  are  usually 
able  to  make  enough  trouble  to  enable  the  average  neurasthenic 
to  get  her  mind  off  herself  for  a  while. 

GOOD   SAMARITAN    WORK 

Those  nervous  patients  who  are  wealthy  or  well-to-do,  who 
have  abundance  of  this  world's  goods  and  are  able  to  enjoy 
every  comfort  of  life,  will  do  a  great  deal  to  cheer  themselves 
up  and  forget  their  troubles  if  they  will  let  themselves  get 
interested  in  their  less  fortunate  fellows  —  their  washerwoman, 
janitor,  scrub-women,  servants,  and  clerks.  It  will  do  them  good 
to  put  on  some  commonplace  clothing  and  go  down  into  the 
slums  and  see  how  the  other  half  has  to  live. 

If  you  would  be  successful  in  completely  and  finally  over- 
coming worry,  do  something  helpful  for  your  neighbor  now 
and  then.  Remember  the  Golden  Rule.  Do  not  allow  your  own 
artificial  needs  to  accumulate  unnecessarily  and  demand  all 
your  time.  Reserve  a  little  energy  for  Good-Samaritan  work, 
and  you  will  finish  the  day's  tasks  refreshed  and  satisfied  in- 
stead of  hungry,  thirsty,  and  dissatisfied;  and  in  doing  Good- 
Samaritan  work  let  us  do  some  real  preventive  work  —  real 
social  service.  It  is  a  grand  and  glorious  thing  to  pick  up  the 
man  wounded  by  thieves  on  the  road  down  to  Jericho,  but  it 
would  be  a  grander  and  more  glorious  service  to  police  the 
Jericho  road  so  efficiently  as  to  render  it  forever  and  entirely 
safe  for  men,  women,  and  children  to  travel  it  by  day  or  by 
night. 


Fig.  19.  Taking  the  Outdoor  "  Play  Cure 


The  Streets  and  Alleys  are  the  Playgrounds  of  the  Slums 


FIG.  21.  GIVE  THE  CHILDREN  A  CHAXCE  TO  PLAY 


SSS; 


THE  SOCIAL  SERVICE  CURE  483 

To  sum  up:     All  chronic  worriers  should  see  to  it  that  they 
have  these  three  things: 

1.  Active  mental  and  physical  employment;  in  other  words, 
a  good  job. 

2.  They    should   have   regular   and   healthful    recreation;    in 
other  words,  a  good  fad. 

3.  They  should  have  suitable  and  regular  spiritual  nourish- 
ment; in  other  words,  a  good  religion. 

THE    SOCIAL    SURVEY 

Turn  missionary  to  the  other  nervous  people  of  your  kind, 
organize  a  committee  of  fifteen,  and  inaugurate  a  social  sur- 
vey of  your  community;  or,  if  you  live  in  a  large  city,  of  your 
ward  or  neighborhood.  Find  out  how  people  live,  where  and 
how  they  spend  their  Sundays  and  their  annual  vacation  (you 
will  be  surprised  to  find  a  lot  of  people  in  this  world  who  never 
have  a  vacation),  find  out  how  many  babies  the  families  of 
the  rich  and  poor  average  and  see  what  is  going  to  become  of 
the  great  American  nation  two  hundred  years  from  now.  See 
where  the  children  play  (Fig.  21),  take  a  bird's-eye  view  of 
your  neighbors.  There  are  a  lot  of  fine  folks  living  around  you, 
and  you  are  not  acquainted  with  them.  Some  are  probably  in 
a  position  to  help  you  where  you  need  help,  while  you  will  be 
able  to  help  them  where  they  most  need  it.  Get  interested  in 
human  beings,  lose  some  of  your  troubles  while  you  mingle 
with  the  great  common  herd.  You  will  feel  ashamed  of  some 
of  your  own  imaginary  difficulties  when  you  see  how  real  are 
the  troubles  of  some  other  people. 

A  few  years  ago  while  lecturing  in  a  western  city,  I  advised 
a  nervous,  self -centered  semi-invalid,  who  implored  me  to  tell 
her  what  she  could  do  to  get  well,  to  begin  a  sociologic  survey 
of  her  community.  She  did  it.  She  is  a  well  woman  today; 
she  has  become  the  Jane  Addams  of  her  community;  in  fact, 
her  reputation  has  become  state  wide.  She  is  the  president  of 
nearly  everything  that  amounts  to  anything  in  the  county,  ex- 
cepting the  banks.  Thousands  of  able  men  and  women  are  dying 
of  mildew  and  stagnation  while  their  neighbors  languish  for 
the  need  of  the  very  efforts  which  would  prove  their  salvation. 


484  WORRY  AND  NERVOUSNESS 

PUBLIC    HEALTH    SERVICE 

What  are  you  doing  to  improve  the  sanitary  and  hygienic 
status  of  your  community?  Is  the  milk  supply  up  to  standard? 
You  don't  know  anything  about  it?  Begin  an  investigation  to- 
day. It  is  a  life  and  death  propositon  with  the  babies,  this 
matter  of  the  quality  of  the  milk  supply.  If  your  health  author- 
ities are  on  the  job  in  this  matter,  cooperate  with  them,  heartily 
support  them.  If  they  are  not,  start  the  ball  rolling,  wake  them 
up.  See  that  the  matter  is  not  neglected  another  day.  Forget 
yourself  while  you  battle  for  better  babies.  Do  something  for 
the  good  of  the  rising  generation. 

What  about  your  water  supply?  Does  your  community  need 
a  new  bond  issue  for  a  better  water  system  and  a  modern, 
up-to-date  system  of  sewage  disposal?  Get  into  politics,  if 
necessary,  to  improve  the  health  of  the  community.  If  you  can't 
get  action  any  other  way,  run  for  office,  be  an  insurgent. 
Learn  how  to  put  things  through  and  put  them  over,  and  if  you 
use  common  sense,  and  do  not  overdo  physically,  by  the  time 
the  campaign  is  over  and  the  victory  won,  you  will  be  half 
cured  of  your  nerves;  or,  if  you  should  lose  the  fight  the  first 
time,  be  game,  be  a  good  loser,  that  is  an  excellent  part  of  the 
practice  of  self-control  which  is  such  a  large  part  of  the  cure 
of  neurasthenia. 

What  about  the  health  of  the  pupils  in  the  public  schools? 
Are  their  throats,  noses,  and  eyes  being  looked  after?  Do  you 
have  medical  inspection  of  your  schools?  If  not,  get  it.  It 
will  do  you  good.  It  will  save  lives  and  help  to  cure  your 
troubles. 

If  we  could  only  organize  and  utilize  the  wasted  nerve  energy 
and  worry-thought  of  our  nervous  patients  —  if  we  could  only 
get  it  diverted  out  of  the  channels  of  self-thought  and  self-pity 
—  we  would  have  a  sufficiently  strong  and  powerful  force  to 
bring  about  the  transformation  of  the  civic  and  social  life  of 
our  towns  and  cities.  Neurasthenics,  when  they  get  busy,  can 
usually  do  things.  A  large  majority  of  the  world's  workers 
have  been  more  or  less  neurotic,  but  they  have  kept  on  the  job. 
They  have  been  sensible.  They  have  chosen  to  wear  out  rather 
than  rust  out.     They  have  preferred  to  fight  the  battle  rather 


THE  SOCIAL  SERVICE  CURE  485 

than  to  bewail  the  handicap.     They  have  chosen  to  "  play  the 
game  "  rather  than  to  worry  over  threatened  defeat. 

Wake  up  and  take  an  active  interest  in  the  public-spirited  im- 
provements of  your  community  or  locality.  The  joy  and  satis- 
faction that  is  sure  to  follow  your  activities  along  these  lines 
will  do  a  great  deal  to  relieve  you  from  the  harassing  fear 
and  gloomy  worries  that  have  so  long  tortured  your  life;  yes, 
which  have  even  prevented  your  living  and  compelled  you 
merely  to  exist. 

LENDING  A   HELPING   HAND 

I  think  I  could  enumerate  at  least  one  hundred  different  pub- 
lic or  quasi-public  movements  of  the  present  day  which  beckon 
the  neurasthenic  to  "  come  over  and  help  us."  The  summer 
vacation  movement  for  working  girls,  the  boys'  clubs  and  girls' 
clubs  of  the  great  cities,  the  big  brother  and  the  big  sister 
movement,  city  mission  and  rescue  work,  sunshine  work  for  the 
shut-ins,  hospital  visitation  and  entertainment,  the  flower  mis- 
sions, children's  aid  societies  and  home  finding  organizations, 
work  for  the  aged,  the  blind,  the  crippled,  the  defective  and  the 
delinquent,  prison  reform,  the  work-house  up-lift  movement, 
tenement  and  the  better  housing  problems,  factory  hygiene  and 
child  labor,  problems  of  the  working  girl  and  regulation  of 
working  hours  for  women,  playgrounds  and  dance  halls,  the 
foreign  immigrant,  workingmen's  compensation  and  old  age 
pensions,  temperance  and  local  option,  women's  clubs  and  suf- 
frage, politics,  religion,  science,  art.  and  literature.  These  and 
scores  of  other  forms  of  altruistic  and  humanitarian  work, 
stand  in  need  of  just  the  thought  and  energy-  which  you  neuras- 
thenics are  daily  wasting  on  yourselves  —  i.  e..  pity,  sympathy, 
and  contemplation.  Come  along,  brother,  sister !  Volunteer, 
enlist  in  the  fight,  take  hold  with  us,  we  are  having  a  good 
time,  we  folks  who  are  doing  the  world's  work  and  trying  to 
reform  our  fellows  !  Join  the  ranks !  The  valiant  fighting  by 
day  and  the  campfire  stories  by  night  will  help  you  to  forget 
yourself;  and.  I  ask.  who  knows  but  you  are  destined  to  be- 
come one  of  the  world's  great  men  or  women  —  great.  I  mean, 
in  the  highest  and  truest  sense,  in  that  you  have  brought  the 


486  WORRY  AND  NERVOUSNESS 

greatest  happiness  and  health  to  the  greatest  number  of  men 
and  women  and  boys  and  girls  of  this  generation,  while  you 
contribute  something  toward  that  reorganization  and  readjust- 
ment of  society  which  will  give  the  boy  and  girl  of  the  next 
generation  a  better  and  more  equal  chance  in  this  great  and 
fascinating  struggle  which  we  call  "  life." 

A  REGULATED  DAILY  PROGRAM 

Now,  after  all  that  we  have  said  about  play  and  recreation, 
fads  and  fancies,  about  the  "  work  cure  "  and  the  "  social  serv- 
ice cure,"  my  readers  will  recognize  the  necessity  of  properly 
adapting  this  advice  to  their  individual  cases.  Xo  one  of  you 
can  do  all  the  things  I  have  recommended.  You  cannot  at  any 
one  time  carry  out  all  the  details  of  the  advice  I  have  given 
you.  What  you  need  to  do  is  to  select  that  advice  and  follow 
those  instructions  which  are  best  suited  to  your  condition  — 
just  as  you  find  yourself  today.  If  you  are  working  hard  you 
may  need  the  "  rest  cure ;  "  if  you  are  idle  and  indolent,  you 
may  need  the  "  work  cure."  Make  out  a  daily  program  which 
is  consistent  with  your  physical  strength  and  your  nervous  en- 
ergy and  then  keep  yourself  healthily  and  wholesomely  busy.  If 
you  do  too  much  at  first  you  will  simply  have  a  set  back,  get 
right  up  and  try  it  over  again.  Let  your  watchword,  yea, 
your  slogan,  ever  be:  "  If  at  first  I  do  not  succeed,  I  will  do  it, 
do  it,  again."  When  you  are  temporarily  trnvarted,  when  you 
are  for  the  time  being  defeated,  rise  right  up,  shake  the  dust 
of  doubt  off  your  feet,  and  exultantly  exclaim,  "  Never  touched 
me  !  Onward !  "  And  with  this  indomitable  and  determined 
spirit,  ultimately  you  are  bound  to  succeed. 

SUMMARY  OF  THE  CHAPTER 

1.  When  trying  to  get  the  mind  off  of  one's  self,  there  is 
nothing  in  the  world  so  absorbing  and  fascinating  as  getting 
interested  in  other  human  beings. 

2.  Nervous  people  must  train  themselves  to  become  more 
tolerant  of  other  people's  opinions.  Intolerance  is  responsible 
for  much  domestic,  commercial,  and  social  friction. 

3.  It  is  an  aid  in  overcoming  our  own  petty  whims  if  we 
cultivate  indulgence  for  the  whimsical  conduct  of  our  friends. 

4.  We  should  remember  that  the  one  who  bears  a  grudge  or 


iili 


THE  SOCIAL  SERVICE  CURE  487 

carries  a  grievance  is  the  one  who  is  most  injured  by  this  un- 
charitable state  of  mind. 

5.  If  you  want  to  get  over  the  "blues"  in  a  hurry,  enlist  in 
the  "  cheering  up  business."'  Work  at  it  from  the  time  you  get 
up  in  the  morning  until  you  go  to  bed  at  night. 

6.  Look  over  your  experience  and  find  out  those  things  you 
should  be  glad  about,  and  then  let  other  people  know  that  you 
are  glad. 

7.  Good  cheer,  laughter,  and  light-heartedness  are  a  real  part 
of  the  cure  of  nervousness. 

8.  Cultivate  the  society  of  children  and  good-natured  adults. 
It  is  always  a  help  to  have  a  bright-faced  baby  in  the  home. 

9.  Take  an  interest  in  those  who  are  less  fortunate  than  your- 
self. Save  a  little  of  your  time  now  and  then  for  good-samari- 
tan  work.     Remember  the  Golden  Rule. 

10.  All  chronic  worriers  need  three  things:  a  good  job,  a 
good  fad,  and  a  good  religion. 

11.  If  you  are  lonely  and  idle,  enlist  others  like  yourself,  and 
undertake  a  social  survey  of  your  community.  You  will  be 
greatly  surprised  and  highly  benefited. 

12.  Get  interested  in  the  public  health  service  of  your  com- 
munity. Investigate  the  milk  and  water  supply.  Help  clean  up 
the  town. 

13.  What  do  you  know  about  your  public  schools?  Do  the 
children  enjoy  medical  inspection?  What  are  you  doing  to  help 
the  movement  for  better  babies? 

14.  The  world  is  dying  for  need  of  just  what  you  are  wasting 
on  yourself;  that  is.  pity,  sympathy  and  energy. 

15.  Get  used  to  doing  things.  Remember  the  majority  of  the 
world's  workers  have  been  more  or  less  neurotic,  but  they  pre- 
ferred to  wear  out  rather  than  rust  out. 

16.  Wake  up  and  lend  a  helping  hand  to  one  or  more  of  the 
reform  movements  or  uplifting  propagandas  in  your  midst.  These 
reforms  need  you,  you  need  them. 

17.  Be  sane  in  your  efforts  to  get  well,  don't  overdo.  Don't 
try  at  one  dose  to  take  all  the  advice  given  in  this  and  pre- 
ceding chapters. 


CHAPTER  XXXVII 
THE  FAITH  AND  PRAYER  CURE  * 

IN  ALL  our  dealings  with  neurasthenia  and  neurasthenics, 
we  must  not  only  remember  that  man  is  instinctively  a 
"  playing  animal,"  but  that  he  is  also  inheritently  a  "  religious 
animal,"  a  moral  being,  and  in  the  matter  of  spiritual  therapeu- 
tics we  must  separate  religion  from  its  current  association  with 
dullness.  I  recently  heard  a  soulful-visaged  lady  say  in  describ- 
ing a  sermon  she  had  just  heard:  "  Oh,  he  preached  such  a  fine 
sermon,  it  made  everybody  feel  so  bad."  I  want  frankly  to 
state  at  the  beginning  of  this  chapter,  that  that  is  not  the  kind 
of  religion  the  author  is  interested  in.  We  must  get  away  from 
the  idea  that  our  spiritual  blessings  are  always  administered  in 
sorrow  and  disguised  with  failure  and  fatigue. 

THE  WORSHIP  INSTINCT 

Worship  is  getting  out  of  fashion.  The  average  man  thinks 
of  it  as  something  medieval  or  obsolete.  He  may  excuse  it 
like  any  other  fondness  for  what  is  old-fashioned;  he  may  find 
it  interesting,  amusing,  even  endearing,  in  those  who  throw 
themselves  into  it  sincerely.  But  in  any  case  he  looks  on  at  it 
as   a   spectator;   it   is  not   for   him. 

Worship  renews  the  spirit  as  sleep  renews  the  body.  Our 
souls  as  well  as  our  bodies  get  drained,  now  and  again,  of 
available  energy.  We  "  go  stale  "  as  Hamlet  did,  and  to  our 
jaundiced  view  the  world  too  becomes  "  stale,  flat,  and  unprofit- 
able," or  "sicklied  o'er  with  the  pale  cast"  of  our  own  low- 


*  In  the  preparation  of  this  chapter  I  have  drawn  freely  from 
that  excellent  book  by  Dr.  Cabot  entitled  What  Men  Live  By,  and 
from  my  own  work,  The  Physiology  of  Faith  and  Fear,  or  the  Mind 
in  Health  and  Disease. 


THE  FAITH  AXD  PRAYER  CURE  489 

grade  cerebration.  This  is  not  always  the  result  of  physical 
fatigue;  for  people  who  never  did  a  stroke  of  work  in  their 
lives  are  as  prone  as  any  to  these  symptoms  of  spiritual  fatigue. 
Nevertheless,  we  attempt  again  and  again  to  shut  ourselves 
off  in  spiritully  unventilated  corners.  There  we  stifle  and  droop. 
Play  and  love  revive  us  partially  because  they  take  us  into  bet- 
ter ventilated,  less  cramped  activities.  Worship  fulfills  what 
play,  art,  and  love  attempt.  "  Pleasure,  recreation,  friendship. 
the  companionship  of  men  and  women,  beauty  —  all  these  recall 
the  outgoings  of  ambition  and  moral  effort  and  untie  a  man 
with  his  natural  appreciation.  Worship  is  the  whole  which 
includes  them." 

Because  worship  is  a  renewal  of  our  depleted  spiritual  energies, 
it  is  naturally  intermittent.  One  need  not  jeer  at  the  worshiper 
for  spending  so  little  time  on  that  which  he  declares  to  be  his  sal- 
vation. For  it  is  in  work,  play,  and  love  that  he  must  earn  the 
right  to  pray  as  he  earns  the  promise  of  sleep.  No  one  can  find 
out  except  by  trying  whether  he  needs  prayer  once  an  hour,  once 
a  week,  or  less  often.  The  rhythm  of  its  recurrence  should  be 
governed  like  that  of  any  physiological  function,  varying  like  food, 
sleep,  and  recreation,  without  expenditures  of  effort  and  energy. 

WHAT   IS   PRAYER? 

It  is  a  favorite  trick  with  those  who  pretend  to  read  the  palm 
to  say,  with  special  emphasis  and  secrecy  to  each  customer: 
"  I  can  see  in  your  hand  that  the  deepest  and  best  of  you  has 
never  yet  found  expression.  Half  unconsciously  you  are  re- 
pressing a  flood  of  power  which  pushes  ever  for  freedom.  To 
set  it  free  will  be  the  deepest  joy  of  your  life." 

The  beauty  of  this  ever-successful  trick  is  that  what  the 
sharper  pretends  to  discover  in  this  individual  he  knows  to  be 
true  of  every  living  being.  We  are  piteously  unexpressed.  We 
differ  only  in  the  means  that  can  set  us  free.  How  many  in 
whom  we  least  suspect  it  are  longings  to  sing  —  not  to  interpret 
a  genteel  melody,  but  to  let  themselves  out  in  song !  The  efforts 
expended  in  business,  in  sport,  and  even  in  affection  seem  com- 
paratively impersonal  and  indirect.  They  do  not  free  the  breast, 
they  do  tell  the  tale. 


49o  WORRY  AND  NERVOUSNESS 

How  many  in  whom  we  least  suspect  it  are  longing  to  pray ! 
How  many  who  hardly  suspect  it  themselves  !  I  believe  that 
the  craving  to  sing  is  but  a  partial  and  imperfect  image  of  the 
craving  to  pray.  What  song  is  to  prosy  speech,  that  prayer  is 
to  song.  It  is  the  supremely  personal  and  direct  utterance  for 
which  all  creation  longs,  for  which  hard  toil  prepares. 

When  we  set  ourselves  to  this  work  of  collecting  or  re-col- 
lecting the  scattered  pieces  of  ourselves,  we  begin  a  task  which, 
if  carried  to  its  natural  conclusions,  ultimately  becomes  prayer. 
We  are  driven  to  something  of  the  sort  when  the  shock  of 
illness,  war,  bankruptcy,  or  death  has  shaken  us  out  of  the  rut 
of  habit  and  brought  us  face  to  face  with  the  mess  which  we 
are  making  of  our  years.  It  was  after  such  a  shock  Lincoln 
called  the  whole  nation  to  prayer  in  his  message  of  December 
i,  1862: 

The  dogmas  of  the  quiet  past  are  inadequate  to  the  stormy  pres- 
ent. The  occasion  is  piled  high  with  difficulty  and  we  must  rise  to 
the  occasion.  As  our  case  is  new,  so  we  must  think  anew  and  act 
anew.  We  must  disenthrall  ourselves  and  then  we  shall  save  our 
country. 

THE  COMFORT  OF  CONFESSION 

When  a  child  wakes  in  the  grip  of  a  nightmare,  sobs,  and 
stammers  it  out  to  his  mother,  and  finds  that  its  horrors  have 
swiftly  vanished,  he  has  discovered  the  value  of  confession. 
Through  expression  something  confused  and  inarticulate  has 
lost  its  terrors.  By  confession  he  marshals  his  troubles  in  con- 
sciousness and  spreads  them  out  in  form  and  order;  thus  he 
gains  command  of  them  and  of  himself. 

Confession  in  more  or  less  secular  forms,  confession  to  a 
doctor  or  a  chum,  gives  some  relief  to  the  tortures  of  internal 
strife  — duplicity  and  fraud,  the  burden  of  lies,  thefts,  treachery, 
or  concealment;  or,  it  may  be,  the  more  subtle  duplicity  of 
warring  ideals,  curiosities,  and  doubts.  In  any  case  we  seek 
instinctively  through  confession  some  inner  peace  or  at  least 
some  truce  to  inner  war.  We  make  these  secular  confessions 
primarily  because  we  cannot  hold  in  any  longer.  We  confess 
not  so  much  because  murder  will  out,  but  rather  because  the 


THE  FAITH  AND  PRAYER  CURE  491 

tension   between   what   we   are   and  what   we   seem   to  be   has 
grown  intolerable. 

An  interesting  variety  of  confession,  rediscovered  and  reapplied 
by  the  German  neurologist,  forms  part  of  the  "psycho-analytic" 
treatment  of  functional  nervous  disorders.  People  suppress  and  try 
to  bury  a  disappointed  hope  or  an  evil  desire;  but  accidentally  they 
bury  it  alive,  so  that  it  struggles  and  shrieks  beneath  the  weight 
of  daily  life  piled  on  top  of  it.  Now  and  then  the  struggles  of 
this  fragment  of  buried  existence  shake  the  surface  of  everyday 
life  and  emerge  in  a  fit  of  weeping  or  of  rage.  "  You  begin  to  cry." 
said  a  small  boy  of  my  acquaintance,  "  for  the  thing  that  made  you 
cry,  but  you  go  on  crying  for  all  the  sad  and  sorry  things  that  ever 
happened.''  You  had  never  quite  destroyed  the  ghost  of  these  an- 
cient sorrows.  From  the  deeper  inconsequent  strata  of  your  exist- 
ence it  rises  to  haunt  and  oppress  you. 

So  in  rage ;  we  begin  to  be  angry  with  a  companion  for  some 
trilling  annoyance,  but  we  go  on  into  a  "  fit  of  rage  "  because 
our  momentary  anger  is  reinforced  by  the  quiescent  memories 
of  a  multitude  of  other  injuries,  long  half-consciously  brooded, 
never  quite  forgiven.  All  this  submerged  corruption  boils  up 
to  the  surface,  and  we  may  work  ourselves  into  a  passion  for  the 
sake  of  the  vent  it  gives  to  our  repressed  and  smouldering 
resentment. 

A  better  vent  is  given  by  full  confession.  To  see  clearly  that 
we  are  abusing  our  fellow  for  his  part  in  spats  which  both 
should  have  forgiven  and  forgotten  long  go,  shames  us  or 
makes  us  laugh.  The  air  is  cleared ;  the  ghosts  of  past  quar- 
rels are  laid.  To  tempt  the  sufferer  into  confessing  what  he 
did  not  know  enough  to  confess,  is  the  substance  of  psychan- 
alysis.  I  have  discovered  that  my  neurotic  patients  do  not  get 
along  well  in  the  presence  of  family  trouble  —  domestic  mis- 
understandings —  and  that  when  we  can  induce  them  to  "  con- 
fess," "  make  up,"  and  "  begin  over  again ;  "  then,  and  not  until 
then,  does  the  patient  with  "  nerves  "  begin  to  improve. 

THE   PSYCHOLOGY  OF   PRAYER 

True  prayer  is  a  sort  of  spiritual  communion  between  man 
and  his  Maker,  a  sympathetic  communication  between  the  soul 


492  WORRY  AXD  NERVOUSNESS 

and  its  Saviour.  We  do  not  look  upon  prayer  as  a  means  of 
changing  God's  will.  The  Divine  Mind  does  not  need  to  be 
changed ;  He  is  ever  beneficent  and  kindly  disposed  toward 
mankind.  While  prayer  does  not  change  God,  it  certainly  does 
change  the  one  who  prays,  and  this  change  in  the  mind  of  the 
praying  soul  is  sometimes  immediate,  profound,  and  often 
wholly  inexplicable. 

True  prayer,  then,  is  found  to  be  a  practice  consisting  of 
powerful  mental,  moral,  and  spiritual  factors.  The  mental  fac- 
tor in  genuine  prayer  is  that  of  suggestion  and  self-surrender. 
Sincere  prayer  is  the  most  powerful  method  and  the  most  le- 
gitimate manner  in  which  suggestion  can  be  made  to  the  human 
mind.  Xot  only  is  the  suggestion  of  prayer  auto-suggestion 
—  the  ideal  form  of  suggestion  —  but  this  suggestion  is  made 
to  the  mind  when  it  is  in  a  state  of  surrender,  unconditional 
surrender  to  the  mind  of  God  and  not  to  the  mind  of  man. 
Psychology  and  psychotherapy  are  unable  to  portray  such  an 
ideal  state  of  the  human  mind  for  the  favorable  reception  of 
suggestion,  neither  can  they  point  out  such  powerful  and  whole- 
some means  of  administering  this  suggestion  as  by  the  simple 
childlike  practice  of  old-fashioned  prayer. 

The  moral  element  of  prayer  is  that  it  keeps  the  mind  focussed 
upon  high  ideals,  upon  things  which  are  ennobling  and  elevat- 
ing. Prayer,  in  an  unusual  manner,  imparts  moral  courage  and 
wholesome  confidence  to  the  suppliant.  Prayer  is  a  direct  pre- 
ventive of  many  of  those  reprehensible  social  and  moral  prac- 
tices which  inevitably  breed  worry,  remorse,  and  sorrow  of 
heart.  Prayer  strengthens  the  will,  in  contra-distinction  to 
hypnotism,  which  usually  weakens  it. 

The  spiritual  factor  in  prayer  is  strong;  no  other  phase  of 
human  experience  is  fraught  with  such  extraordinary  possibil- 
ities for  spiritual  strength  and  development.  Prayer  actually 
generates  moral  energy  and  creates  spiritual  courage.  The 
prayer  life  is  the  life  of  spiritual  power  and  moral  victory. 

THE  PHYSIOLOGY  OF  PRAYER 

The  domain  of  prayer  is  not  limited  alone  to  the  spiritual, 
moral,  and  mental  realms;  it  concerns  and  influences  even  the 


' 


THE  FAITH  AND  PRAYER  CURE  493 

physical  body.  The  praying  soul  usually  is  found  upon  bended 
knees  and  with  bowed  head.  This  bending  of  the  physical  knee 
reflexly  aids  in  bending  the  will  and  the  mind  of  the  one  who 
prays.  There  is  a  close  interrelationship  between  the  attitude 
of  body  and  the  attitude  of  mind. 

Prayer  is  able,  directly,  immediately,  most  powerfully,  and 
most  favorably  to  influence  the  physical  functions  of  the  body ; 
that  is,  genuine  prayer,  the  prayer  of  faith,  exerts  its  beneficent 
influence  upon  the  body,  while  other  kinds  of  prayer  may  be 
highly  injurious  to  the  physical  health,  as  will  be  noted  pres- 
ently. True  praying  assists  the  petitioner  in  gaining  control 
over  various  physical  propensities  and  animal  passions. 
Prayer  is  a  means  of  bringing  the  body  into  subjection  to  the 
mind,  and  the  mind  into  obedience  to  the  spiritual  faculties 
and  to  the  Divine  Mind. 

THE  THERAPEUTICS   OF   PRAYER 

Any  practice  that  can  wield  such  a  mighty  influence  over 
mind  and  body  as  that  exerted  by  prayer  must  indeed  possess 
tremendous  therapeutic  possibilities.  In  discussing  prayer  as  a 
therapeutic  agent,  we  in  no  way  aim  to  belittle  its  influence  as 
a  religious  practice  or  a  spiritual  force.  We  freely  concede  that 
its  power  is  almost  unlimited  in  these  realms.  In  his  Varieties 
of  Religious  Experience,  Professor  James  says: 

As  regards  prayer  for  the  sick,  if  any  medical  fact  can  be  con- 
sidered to  stand  firm,  it  is  that  in  certain  environments,  prayer  may 
contribute  to  recovery,  and  should  be  encouraged  as  a  therapeutic 
measure. 

Just  a  few  days  ago  I  had  an  opportunity  of  observing  the 
tremendous  power  and  possibility  of  prayer  in  the  management 
of  these  nervous  sufferers.  Mrs.  M.  is  a  refined,  highly-edu- 
cated patient,  whom  I  had  seen  a  number  of  times  in  consulta- 
tion with  Dr.  Lena  —  my  wife  —  and  had  advised  the  doctor 
that  I  did  not  look  for  much  improvement  in  her  patient  until 
her  (the  patient's)  mental  life  was  set  in  order  and  certain  and 
numerous  psvehic  slivers  were  effectually  removed.  In  reply 
to  Dr.  Lena's  question  as  to  how  long  I  thought  it  would  take 


494  JVORRY  AND  NERVOUSNESS 

to  get  her  out  of  her  trouble,  I  said:  "  Probably  a  year  and  a 
half.*'  Imagine  my  surprise  when  this  patient  walked  into 
my  office  yesterday  and  informed  me  that  her  "  troubles  were 
all  over,"  that  the  things  she  assured  me  a  few  days  ago  she 
'•  could  never  do,"  had  all  been  done.  That  everything  I  had 
asked  her  to  do  as  a  part  of  her  "  cure  "  had  been  accom- 
plished —  she  had  completely  overturned  her  social,  family,  and 
personal  life  —  had  made  numerous  "confessions,"  and  had  ac- 
complished a  score  of  almost  impossible  mental  and  moral 
"  stunts,"  and  in  reply  to  my  astonished  question,  "  How  in  the 
world  did  you  ever  do  all  these  things  and  effect  this  great 
change  in  your  mental  attitude  toward  yourself  and  the  world 
in  less  than  one  week?"  she  smilingly  replied:  "Dr.  Lena 
taught  me  how  to  pray." 

THE  PERVERSION    OF   PRAYER 

But  many  who  are  aware  of  God,  and  try  to  live  according 
to  what  they  believe  to  be  his  will,  still  feel  that  petition  is  a 
relic  of  barbarous  or  of  naive  ages,  something  not  to  be  taken 
seriously  by  reasonable  people.  Prayers  for  rain,  for  victory 
in  battle,  for  the  recovery  of  the  sick  —  what  are  these  but 
frantic  attempts  to  break  the  laws  of  nature?  And  even  if 
they  could  succeed,  would  they  not  be  grossly  selfish?  For  my 
victory  is  often  another's  despair.  The  rain  which  falls  on  my 
crops  leaves  my  distant  neighbor's  all  the  longer  in  drought. 
But  if  we  admit  that  "  all  prayer  that  craves  a  particular  com- 
modity—anything less  than  all  good  —  is  mean  and  vile,"  do 
we  eliminate  all  the  prayers  that  any  needy  mortal  wants 
to  make?  "All  good"  is  a  pretty  large  order  and  a  tolerably 
vague  one.  In  answer  to  this  question,  which  often  troubled 
me  in  past  years,  Christ's  words  in  the  garden  of  Gethsemane 
now  seem  wholly  satisfying:  "Father,  if  thou  be  willing,  re- 
move this  cup  from  me:  nevertheless  not  my  will,  but  thine, 
be  done." 

Whoever,  by  religious  instinct  or  religious  philosophy,  has 
come  to  believe  that  the  universe  is  a  team  of  which  he  is  a 
member,  wants  the  success  of  the  team  unconditionally  and  with 
his  whole  heart,  and  wants  nothing  else,  save  with  the  condi- 


THE  FAITH  AND  PRAYER  CURE  495 

tion,  "  provided  this  does  not  contravene  the  needs  of  the 
team."  Such  is  the  spirit  of  Christ's  prayer.  Obviously  then, 
conditional  wishing  is  part  of  our  daily  exercise.  The  babyish 
tendency  to  "  want  what  you  want  when  you  want  it "  is 
squelched  or  modified  in  every  piece  of  concerted  work,  in 
every  advance  of  science,  and  every  harmonious  family.  To 
revise  and  subordinate  our  wills  until  they  are  conditional  on 
the  success  of  a  city,  a  party,  or  any  other  team  to  which  we 
are  loyal  is  among  the  most  familiar  and  unheroic  necessities 
of  civilized  life. 

In  this  connection  we  desire  to  utter  a  warning  against  mor- 
bid methods  of  prayer.  Xo  procedure  is  capable  of  great 
good  without  at  the  same  time  being  susceptible  of  perversion 
and  great  harm.  Another  case  will  illustrate  the  harm  of 
prayer,  when  it  consists  of  a  meaningless  recital  of  one's  diffi- 
culties, serving  as  a  source  of  adverse  autosuggestion  to  the 
mind.  Such  methods  of  prayer  tend  to  weaken  and  debilitate 
the  mental  and  moral  powers.  Several  years  ago  I  had  a  pa- 
tient, a  young  man,  twenty-two  years  of  age,  who  was  fighting 
a  great  moral  battle.  He  became  very  much  discouraged ;  broke 
off  his  marriage  engagement ;  severed  his  connection  with  the 
church ;  and  at  the  time  we  met  him,  seriously  contemplated 
suicide.  Having  tried  numerous  methods  of  giving  him  help 
and  relief,  we  finally  made  bold  to  advise  that  he  was  in  need 
of  moral  strength  —  spiritual  power  —  and  suggested  that  he 
would  find  great  help  in  systematic  prayer.  To  this  he  replied: 
"  Why,  doctor,  I  have  prayed  about  my  troubles  until  two  o'clock 
in  the  morning,  and  then  after  my  great  struggle  with  God,  I 
would  soon  fall  again  into  my  sin.  The  more  I  pray,  the 
worse  I  get;  nothing  will  do  me  any  good.  It  is  either  the 
insane  asylum  or  the  grave  for  me."  After  listening  to  this 
recital  of  his  experience,  it  occurred  to  me  that  in  his  case, 
prayer  was  being  prostituted  into  a  form  of  adverse  and  un- 
wholesome suggestion ;  that  he  had  prayed  about  his  moral 
perversity  so  much  that  this  very  praying  had  become  a  direct 
aid  in  keeping  the  wicked  idea  everlastingly  before  his  mind. 
Instead  of  making  a  helpful  and  uplifting  suggestion  out  of 
prayer,  he  was  making  it  harmful  and  debasing.     And  so  we 


496  WORRY  AND  NERVOUSNESS 

made  bold  to  suggest  the  following  procedure  in  his  case :  We 
asked  him  to  reunite  with  the  church;  to  see  his  fiancee  and  set 
a  new  wedding-day;  to  begin  to  lay  plans  for  securing  a  flat, 
and  actively  to  engage  in  selecting  the  furnishings.  We  asked 
him  to  let  his  mind  freely  dwell  upon  the  happy  home  he  would 
have  and  the  splendid  children  who  would  come  to  bless  it. 
We  had  him  sign  a  written  agreement  not  to  think,  talk,  or 
pray  about  his  troubles  for  two  weeks.  We  explained  to  him  as 
best  we  could,  that,  when  he  had  asked  his  Heavenly  Father  to 
help  him  in  a  matter  of  this  kind,  it  was  not  necessary  to  ask 
more  than  once ;  that  further  prayer  should  be  devoted  to  thank- 
ing God  for  the  help  that  was  to  come  and  in  expressing  grati- 
tude for  the  help  that  even  now  had  already  come. 

We  are  glad  to  report  that  in  this  case,  after  his  method 
of  praying  had  been  turned  from  one  of  constant  adverse  sug- 
gestion into  one  of  thanksgiving  and  gratitude,  he  was  highly 
successful.  From  that  day  on,  this  young  man  became  an 
absolute  victor  over  his  besetting  sin.  And  so  it  is  apparent 
that  prayer  can  be  so  perverted  as  to  become  a  means  of  great 
harm  as  a  therapeutic  procedure.  The  author's  highest  con- 
ception of  prayer  is  that  silent  and  spiritual  communion  be- 
tween the  spirit  of  the  creature  and  the  Spirit  of  his  Maker. 
In  the  early  stages  of  therapeutic  praying  it  is  very  necessary 
that  the  prayer  should  be  calmly  and  distinctly  uttered  in 
words,  that  the  petitioner  may  hear  his  own  prayer,  for  this 
greatly  increases  the  influence  and  suggestive  powTer  of  the 
procedure. 

PRAYER  AX   IXSPIRATIOX  TO  WORK 

Prayer  is  not  only  a  means  whereby  the  mind  of  man  and 
the  divine  forces  are  brought  into  cooperation,  but,  if  it  is 
uttered  in  faith,  it  usually  leads  the  one  who  prays  to  put 
forth  every  effort  to  bring  about  the  answer  of  his  prayers. 
Genuine  prayer  is  an  expression  of  courage  and  confidence 
combined  writh  faith  and  good  wrorks. 

Although  prayer  is  a  powerful  therapeutic  agent,  we  must 
fully  recognize  that  neither  belief  in  our  prayers,  nor  sugges- 
tion,  nor   reeducation   will   take  the  place   of  proper   physical 


THE  FAITH  AXD  PRAYER  CURE 

ministrations  and  the  scientific  care  of  the  diseased  or  dis- 
ordered body.  Prayer  may  be  the  breath  of  the  soul ;  prayer 
may  be  the  avenue  whereby  the  diseased  mind  is  eliminated  and 
the  Divine  Mind  brought  in  to  replace  it;  prayer  is  the  great 
channel  by  which  man  can  harmonize  his  mind  with  that  of  his 
Maker.  Nevertheless,  good  food,  pure  water,  fresh  air,  sound 
sleep,  and  deep  breathing,  together  with  mental  and  physical 
exercise,  are  absolutely  essential  to  the  recovery  of  most  nerv- 
ous and  psychic  disorders. 

We  do  not  teach  that  prayer  should  not  be  used  as  a  safety- 
valve  for  the  soul.  It  is  far  better  when  the  feelings,  the 
emotions,  and  the  internal  pressure  have  arisen  almost  to  the 
bursting  point  —  it  is  far  better  for  the  Christian  to  pour  out  his 
soul  to  God  in  prayer,  than  to  participate  in  an  outburst  of 
anger  or  to  indulge  in  a  fit  of  bad  temper.  If  it  is  absolutely 
necessary  that  one  should  have  a  vent  of  some  sort  to  relieve 
himself,  prayer  will  be  found  to  be  a  successful  and  satisfactory 
mode  of  obtaining  such  relief.  Even  when  prayer  is  accom- 
panied by  more  or  less  weeping  and  wailing,  it  is  certainly 
preferable  to  a  hysterical  outbreak  or  to  a  verbal  explosion  of 
raving  and  ranting. 

CHRISTIANITY   THE    HIGHEST   PSYCHOTHERAPY 

We  are  forced  to  recognize  the  therapeutic  value  of  prayer, 
no  matter  with  what  system  of  belief  or  religion  it  may  be  asso- 
ciated; but  we  have  spoken  of  prayer  in  this  text  with  the 
thought  of  its  being  a  part  of  practical  Christianity.  The  author 
regards  prayer  as  the  master  mind  cure,  and  Christianity  as 
the  highest  and  truest  form  of  psychotherapy.  There  can  be 
no  question  that  the  Christian  religion,  when  properly  under- 
stood and  truly  experienced,  possesses  power  both  to  prevent 
and  cure  numerous  mental  maladies,  moral  difficulties,  and 
physical  disorders.  It  must  be  evident  to  the  reader  that  fear 
and  doubt  are  disease-producing,  while  faith  and  hope  are 
health-giving;  and  in  the  author's  opinion,  the  highest  possi- 
bilities of  faith  and  the  greatest  power  of  hope  are  expressed 
in  the  Christian  religion.  The  teachings  of  Christ  are  the 
greatest  known  destroyers  of  doubt  and  despair. 


498  WORRY  AND  NERVOUSNESS 

No  one  can  appreciate  so  fully  as  a  doctor  the  amazingly 
large  percentage  of  human  diseases  and  sufferings  which  are 
directly  traceable  to  immorality,  dissipation,  and  ignorance  — 
to  unwholesome  thinking  and  unclean  living.  The  sincere  ac- 
ceptance of  the  principles  and  teachings  of  Christ  with  respect 
to  the  life  of  mental  peace  and  joy,  the  life  of  unselfish  thought 
and  clean  living,  would  at  once  remove  more  than  one-half 
the  difficulties,  diseases,  and  sorrows  of  the  human  race.  In 
other  words,  more  than  one-half  of  the  present  afflictions 
of  mankind  could  be  prevented  by  the  tremendous  prophylactic 
power  of  the  Christian  religion. 

Christianity  applied  to  our  modern  civilization  —  under- 
standing^ applied,  not  merely  believed  or  accepted  —  would 
so  purify,  uplift,  and  vitalize  us  that  the  human  race  would 
immediately  stand  out  as  a  new  order  of  beings,  possessing 
superior  mental  power  and  increased  physical  force.  Irre- 
spective of  the  future  rewards  of  the  Christian  religion,  laying 
aside  all  discussion  of  future  life,  it  would  pay  any  man  or 
woman  to  live  the  Christ-life  just  for  the  mental  and  physical 
rewards  which  it  affords  here  in  this  present  world.  Some  day 
the  world  may  awake  to  the  point  where  it  will  recognize  that 
the  teachings  of  Christ  are  potent  and  powerful  in  the  work 
of  preventing  and  curing  disease.  Some  day  our  wonderful 
boasted  scientific  developments,  as  regards  mental  and  moral 
improvement,  may  indeed  catch  up  with  the  teachings  of  the 
Christian  religion. 

FAITH    AS   A   REMEDY 

And  so,  having  advanced  in  modern  therapeutics  to  that 
point  where  we  recognize  the  necessity  of  treating  the  whole 
physical  body  in  most  cases  of  common  disorders,  the  time 
is  certainly  ripe  for  a  further  forward  movement  in  the 
scientific  and  sensible  treatment  of  human  disease.  The  next 
great  advance  in  modern  therapeutics  consists  in  a  greater 
recognition  of  the  importance  of  treating  not  merely  the  whole 
body,  but  of  administering  therapeutically  to  the  whole  man  — 
to  the  mental  man  and  the  moral  as  well  as  to  the  material 
man;  to  the  psychic  man  as  well  as  to  the  physical  man. 


Mi 


THE  FAITH  AXD  PRAYER  CURE  499 

The  people  are  hungry  for  sympathy,  for  encouragement,  for 
advice  and  guidance;  and,  in  the  light  of  modern  psychology, 
we  are  forced  to  recognize  that  all  systems  of  religious  belief, 
more  or  less,  afford  this  psychic  help.  Every  phase  of  religious 
teaching  which  specializes  on  divine  healing,  is  moving  for- 
ward in  the  world  with  great  rapidity.  The  Roman  Catholic 
Church  undoubtedly  holds  many  of  its  members  because  of 
the  peculiar  mental  relief  afforded  by  the  confessional.  Troubled 
souls  unbosom  their  sorrows  and  go  away  consoled,  and,  of 
course,  physically  and  psychically  helped  in  proportion. 

Faith,  as  used  in  this  text,  means  decidedly  more  than  mere 
belief.  Living  faith  is  not  merely  a  theological  adjunct  to  a 
theoretical  religion.  Faith  is  a  vitalizing  attribute  of  the  human 
mind  —  it  possesses  tremendous  physical  possibilities  and  extra- 
ordinary therapeutic  powers.  Tolstoi  once  called  faith  "  the 
force  of  life." 

Faith  means  more  than  belief.  To  believe  a  thing  is  merely 
to  accept  it  by  our  reason ;  to  realize  that  no  facts  or  logical 
consideration  of  any  kind  exist  which  can  prevail  against  it. 
Faith  implies  such  acceptance  even  in  the  face  of  considerations 
of  fact  or  of  logic ;  their  reality  may  be  recognized,  but  they 
are  consistently  ignored  when  they  appear  in  relation  to  the 
object  of  our  faith.  Faith  calls  for  a  complete  and  unconstitu- 
tional surrender  of  one's  whole  body,  soul,  and  spirit,  to  the 
idea  or  thing  which  is  believed  in.  Faith,  of  necessity,  must 
further  include  the  idea  of  obedience  to  that  which  it  accepts. 

Belief  only  requires  the  cooperation  of  the  intellectual  powers, 
and  an  impartial  distribution  of  the  affections,  over  the  whole 
field  of  those  mental  processes  by  the  activity  of  which  belief 
is  attained.  Faith  demands  the  consecration  of  the  whole  mind, 
the  concentration  of  the  affections  upon  a  given  idea  or  upon 
a  preconceived  object.  Faith  demands  and  implies  a  thorough 
control  of  the  emotions;  the  cooperation  of  the  spiritual  forces 
on  the  one  hand,  and  the  physical  forces  on  the  other.  The 
highest  known  development  of  faith  is  to  be  found  in  the 
faith  of  Christianity,  which  represents  the  most  all-inclusive,  the 
most  powerful  and  transcendent  mental  action,  moral  exercise, 
and  spiritual  force  known  to  man.     The  "  Faith  of  Jesus  "  is 


500  WORRY  AND  NERVOUSNESS 

a  supernatural  power  —  divine  attribute,  and  must  not  be  con- 
fused with  our  discussions  of  faith  in  the  psychologic  sense. 

The  religions  of  modern  times  have  been  in  imminent  danger 
of  becoming  weak  and  effeminate.  The  world  today  needs  more 
of  the  militant  but  wisely  directed  spirit  of  the  early  Christian 
religion.  We  must  come  to  exercise  more  faith  and  manifest 
more  determination  in  the  pursuit  of  the  higher  and  nobler  aims 
of  life.  Faith  is  a  tremendous  motive  power  and  when  it  once 
dominates  the  soul,  it  is  able  to  harness  the  mind  and  control 
the  body;  it  is  able  to  combat  disease  and  relieve  suffering; 
yes,  it  is  able  to  vanquish  sorrow  and  establish  peace. 

RELIGIOUS    STOICISM 

It  is  dangerous  to  go  through  life  without  religion  and  with- 
out philosophy.  I  can  even,  without  doing  any  wrong  to  the 
believers,  say  plainly  "without  philosophy";  for  religion  itself 
can  be  efficacious  only  when  it  creates  a  living  philosophy  in 
him  who  practices  it. 

Religious  faith  would  be  the  best  preventative  against  the 
maladies  of  the  soul  and  the  most  powerful  means  of  curing 
them  if  it  had  sufficient  life  to  create  true  Christian  stoicism  in 
its  followers.  In  this  state  of  mind,  which  is,  alas  !  so  rare  in 
the  thinking  world,  man  becomes  invulnerable.  Feeling  himself 
upheld  by  his  God,  he  fears  neither  sickness  nor  death.  He 
may  succumb  under  the  attacks  of  physical  disease,  but  morally 
he  remains  unshaken  in  the  midst  of  his  sufferings,  and  is 
inaccessible  to  the  cowardly  emotions  of  nervous  people.  He 
proves  that  "  perfect  love  casteth  out  all  fear." 

There  can  be  no  doubt  that  religious  suggestion  is  far  more 
powerful  with  the  average  individual  than  secular  suggestion. 
Religious  suggestions  probably  carry  a  greater  force  because 
of  their  power  to  appeal  to  a  far  greater  group  of  psychic 
powers  and  spiritual  energies.  The  feelings  and  emotions  are 
usually  considerably  aroused  in  connection  with  religious  sug- 
gestion, and  it  is  well-known  that  suggestions  are  frequently 
welded  on  to  the  mind  in  exact  proportion  to  the  height  of 
the  feelings  and  the  intensity  of  the  emotions.  Not  that  one 
cannot  secure  new  ideas  without  feeling  or  emotion,  but  rather 


THE  FAITH  AXD  PRAYER  CURE  501 

that  feeling  and  emotion  quickly  cause  the  new  idea  to  become 
a  permanent  part  of  the  old  mind. 

THE  MORAL  NUTRITION 

Some  one  has  suggested  that  worry  should  be  treated  by 
dogma  and  not  by  drugs,  and  this  is  good  advice  so  far  as  it 
goes.  The  author  regards  the  Christian  religion  as  the  ideal 
system  of  mind  treatment  —  a  real  and  efficient  system  of 
psychotherapy.  Prayer  is  the  most  powerful  and  effectual 
worry-remover  with  which  we  are  acquainted.  That  man  or 
woman  who  has  learned  to  pray  with  childlike  sincerity,  literally 
talking  to  and  communing  with,  the  Heavenly  Father,  is  in  pos- 
session of  the  great  secret  whereby  he  or  she  can  cast  all  their 
care  upon  God,  knowing  that  He  careth  for  us.  A  clear  con- 
science is  a  great  step  toward  barricading  the  mind  against 
the  entrance  of  worry.  A  moral  taint  of  whatever  sort  is 
bound  to  breed  mental  uneasiness  and  result  in  destroying 
perfect  balance  and  poise  of  mind. 

We  believe  many  are  victims  of  fear  and  worry  because  they 
fail  properly  to  maintain  their  spiritual  nutrition.  As  our 
perceptions,  memories,  emotions,  and  thoughts  control  our  bodies, 
so  our  unthought  aspirations,  our  unsatisfied  spiritual  yearn- 
ings for  those  things  that  are,  but  for  us.  perhaps,  not  yet  — 
those  indefinable  experiences  within  us.  which,  taken  all  to- 
gether, we  commonly  call  the  soul  —  these  in  turn  contribute 
balance,  direction,  and  inspiration  to  our  intellectual  powers. 
The  majority  of  people  liberally  feed  their  bodies,  and  many 
make  generous  provision  for  their  mental  nourishment;  but 
the  vast  majority  leave  the  soul  to  starve,  paying  very  little 
attention  to  their  spiritual  nutrition,  and  as  a  result  the  spiritual 
nature  is  so  weakened  that  it  is  unable  to  exercise  that  restrain- 
ing influence  over  the  mind  which  would  enable  it  to  surmount 
its  difficulties  and  live  in  an  atmosphere  above  despair  and 
despondency. 

We  believe  that  perfect  trust  in  a  Supreme  Being  is  one 
of  the  essential  steps  in  the  successful  treatment  and  effectual 
deliverance  from  the  bondage  of  nervousness  and  worry.  If 
your  religion  does  not  help  you  in  these  matters,  if  it  does  not 


502  WORRY  AND  NERVOUSNESS 

change  you,  then  it  would  be  better  to  change  your   religion 
and  get  one  that  does. 

Gladstone  was  once  asked  what  kept  him  so  serene  and 
composed  in  the  midst  of  his  busy  life,  and  replied:  "  At  the 
foot  of  my  bed,  where  I  can  see  it  on  retiring  and  on  arising 
in  the  morning,  are  the  words,  '  Thou  wilt  keep  him  in  perfect 
peace  whose  mind  is  stayed  on  Thee,  because  he  trusteth  in 
Thee.'  "  There  is  good  mental  therapeutics  in  that  old  method, 
called  the  "  practice  of  the  presence  of  God." 

SUMMARY  OF  THE  CHAPTER 

1.  In  our  dealings  with  neurasthenia  and  neurasthenics,  we 
must  not  only  remember  that  man  is  a  "  playing  animal,"  but  that 
he  is  also  a  "  religious  animal." 

2.  The  instinct  to  worship  is  inherent  in  normal  mankind ; 
it  is  a  universal  instinct,  present  in  all  races  and  peoples. 

3.  Worship  refreshes  the  inner  soul.  It  fulfills  what  play, 
art,  and  love  attempt  to  supply. 

4.  Prayer  and  worship  are  avenues  of  self-expression  for 
mind  and  soul.  Many  dissatisfied,  self-centered  souls  are  starv- 
ing —  longing  to  pray  —  but  they  don't  know  it. 

5.  Confession,  whether  it  be  secular  or  religious,  is  the  source 
of  the  greatest  possible  comfort  to  the  anxious  and  burdened 
neurotic  soul. 

6.  We  are  sometimes  literally  compelled  to  confess,  because 
the  tension  between  what  we  are  and  what  we  seem  to  be  grows 
to  be  intolerable. 

7.  Our  past  troubles  insist  upon  making  us  present  trouble 
because  they  were  so  often  buried  alive  in  our  memories. 

8.  Psychanalysis  is  merely  a  scientific  scheme  for  tempting 
nervous  sufferers  into  confessing  what  they  do  not  know  enough 
to  confess  of  their  own  volition. 

9.  True  prayer  is  a  sort  of  spiritual  communion  between  man 
and  his  Maker.  It  does  not  change  God  but  profoundly  af- 
fects the  one  who  prays. 

10.  Prayer  is  the  ideal  mode  of  practicing  autosuggestion. 
It  represents  the  ideal  psychotherapeutic  mental  state. 

11.  The  moral  element  of  prayer  is  that  it  keeps  the  mind 
focused  upon  high  ideals,  upon  ennobling  and  elevating  themes. 

12.  Prayer  is  able  most  powerfully  and  profoundly  to  influ- 
ence even  the  physical  functions  of  the  body.  It  is  of  great  help 
in  the  control  of  the  emotions  and  passions. 

13.  Prayer  is  an  invaluable  therapeutic  aid  in  the  management 
of  chronic  nervous  worriers  —  those  lacking  self-control. 


THE  FAITH  AND  PRAYER  CURE 


503 


14.  Prayer  is  susceptible  of  much  perversion  and  prostitu- 
tion, and  when  thus  practiced  readily  defeats  its  own  purpose. 

15.  "  Nevertheless,  thy  will,  not  mine,  be  done,"  is  the  sub- 
missive attitude  which  characterizes  every  genuine  prayer-peti- 
tion. 

16.  The  greater  part  of  our  modern  praying  is  but  the  expres- 
sion of  selfish  desires,  which  if  answered  would  work  hardship 
upon  our  fellows: 

17.  Morbid  habits  of  prayer  —  meaningless  repetitions  of  one's 
sins  and  sorrows  —  only  serve,  by  auto-suggestion,  to  confirm 
our  infirmities. 

18.  Prayer  is  an  inspiration  to  work.  It  is  an  expression  of 
courage  and  confidence  combined  with   faith  and  good  works. 

19.  While  prayer  aids  the  patient  in  harmonizing  his  mind 
with  that  of  his  Maker;  nevertheless,  prayer  cannot  take  the 
place  of  good  hygiene  and  sanctified  common  sense. 

20.  Prayer  is  the  master  mind  cure  and  Christianity  is  the 
highest  and  truest  form  of  psychotherapy. 

21.  Faith  is  a  real  force  in  treating  nervousness.  It  assists 
in  controlling  the  emotions  and  correlates  the  mental,  physical, 
and  spiritual  forces. 

22.  Faith  is  able  to  harness  the  mind,  dominate  the  soul, 
control  the  body,  combat  disease,  relieve  suffering,  and  vanquish 
worry. 

23.  Faith  breeds  religious  stoicism.  With  God  behind  him, 
man  becomes  fearless  of  disease  and  death,  much  less  can  he  be 
frightened  by  his  nervous  emotions. 

24.  Many  persons  fall  victims  to  chronic  worry  because  they 
fail  to  maintain  their  spiritual  nutrition.  The  human  soul  must 
be  watered  and  fed. 

25.  Perfect  trust  in  a  Supreme  Being  is  one  of  the  essentials 
to  deliverance  from  the  bondage  of  nervousness  and  worry. 


CHAPTER  XXXVIII 
TRIUMPHANT  SELF-MASTERY 

AXD  now  we  have  come  to  the  summing  up  —  the  round  up. 
i  We  have  carefully  gone  into  the  causes  of  nervousness  and 
have  freely  discussed  the  cure  of  worry,  and  now  in  this  chapter, 
I  must  take  leave,  say  farewell  to  my  readers.  And  I  somehow 
feel  I  will  be  forgiven  if  I  presume  to  exhort  a  bit  —  to  indulge 
in  a  little  preachment,  for  in  the  writing  of  this  book  I  have 
endeavored  to  come  very  close  to  the  reader,  just  as  I  would 
in  the  consulting  room. 

THE    MASTERY    OF    YOUR    MOODS 

All  the  advice  contained  in  this  book  will  do  you  little  good 
unless  you  begin  to  put  some  part  of  it  into  actual  practice ; 
unless  you  really  begin  to  act  on  it,  resolve  from  now  on  to  be  a 
mental  master  of  your  own  moods,  a  brave  captain  of  your 
own  mind.  Practice  grit  and  gumption  on  yourself  and  see 
that  things  begin  to  happen  in  the  long  drawn  out  battle  with 
your  nerves.  Teach  yourself  not  to  want  the  things  you  cannot 
get  —  to  be  satisfied  with  what  you  are  and  what  you  have. 
Practice  contentment  with  the  things  of  today,  while  you 
intelligently  and  diligently  sow  the  seed  for  a  better  tomorrow. 
Live  successfully  and  efficiently  one  day  at  a  time.  Do  not 
waste  your  strength  in  grieving  over  the  past  or  squander  all 
your  energy  in  an  effort  to  encompass  the  future.  Do  the  real 
things  of  today  and  let  the  rest  go  undone. 

Brace  up  and  be  a  man.  Cheer  up  and  be  womanly.  Don't 
allow  your  digestive  disturbances,  rainy  days,  hot  weather,  busi- 
ness troubles,  or  family  friction,  to  get  on  your  nerves  or  upset 
your  mental  equilibrium.  Stay  on  your  feet,  don't  be  flabber- 
gasted by  every  silly  emotion  that  threatens  to  sweep  over  your 
soul.     Stand  up  like   a  brave   soldier  in  the   struggle   of  life, 

504 


TRIUMPHANT  SELF-MASTERY  505 

be  a  fearless  fighter  in  the  battle  of  faith  against  fear.  The 
fight  may  be  hard  and  the  struggle  may  be  long,  but  the  victory 
of  self-mastery  will  more  than  a  thousand  times  repay  you  for 
every  effort  and  hardship  which  the  conflict  may  impose. 

EMOTIONAL   TRAINING 

Every  human  emotion,  however  overpowering  and  unruly  it 
may  appear  in  one's  life  today,  is  susceptible  of  being  trained 
—  of  being  intelligently  and  completely  controlled.  Even  if  we 
are  not  able  to  educate  animals,  we  can  efficiently  train  them; 
and  so  the  most  lawless  of  emotional  neurasthenics  and  hysterics 
can  be  retrained  if  they  are  but  willing  to  submit  to  the  neces- 
sary discipline. 

The  real  work  in  the  training  and  disciplining  of  the  emotions 
should  begin  in  early  childhood,  and  in  this  connection  I  can 
do  no  better  than  to  quote  Dr.  Jacoby's  well  chosen  words : 

To  impress  the  youthful  brain  with  noble  and  beautiful  thoughts 
is  but  one  function  of  educational  training.  It  is  quite  as  impor- 
tant to  regulate  by  means  of  habit  the  flow  of  ideas,  the  impulses 
of  the  will,  and  their  dependent  actions,  so  that,  as  an  integral  pos- 
session, they  will  fortify  the  personality  for  its  battle  of  life.  It  is 
true  the  ideal,  a  healthy  mind  in  a  healthy  body,  can  but  rarely  be 
fully  realized,  but  it  is  better  to  have  a  healthy  and  efficient  brain 
in  a  crippled  body  than  a  crippled  mind  in  a  normal  body. 

Child-training,  however,  is  not  the  sole  task  of  psychoprophylactic 
treatment.  Adults,  too  require  training — frequently  more  so  than 
children.  Consider,  for  example,  those  drones  of  wealth  whose 
entire  lives  are  filled  with  outward  form  and  trivialities,  whose 
lack  of  serious  purpose  makes  them  easy  victims  to  the  unbridled 
play  of  their  imaginations.  Constituting,  as  they  do,  so  large  a 
proportion  of  sufferers  from  neurasthenia  and  other  psycho- 
neuroses,  they  teach  us  particularly  that  inordinate  relaxation  leads 
to  imaginary  disorder,  ideational  diseases,  quite  as  much  as  does 
over-taxation  through  work. 

Let  us  here  emphasize  the  principle  that  health  cannot,  as  Hoff- 
mann expresses  it,  be  absorbed  in  comfortable  repose  with  the  aid 
of  a  drug,  but  must  be  acquired  and  maintained  through  useful 
work.  When  races  or  individuals,  enervated  through  luxurious 
living,  unwilling  to  accept  further  cares  or  obligations,  tend  toward 
"  race-suicide  "  through  their  need   for  repose,  and,  worshipping  a 


506  WORRY  AXD  XERVOUSNESS 

morbid  feminism,  look  on  hard  work  as  a  disgrace,  they  represent 
the  dead  twigs  of  humanity,  which  have  fallen  and  must  be  replaced 
by  fresh  shoots;  they  have  become  useless  and  must  give  place  to 
those  who,  through  earnest  work,  have  remained  young,  strong  and 
active. 

THE   MORAL    MASTERY 

The  so-called  moral  powers  are  capable  of  exerting  a  tre- 
mendous influence  in  the  control  of  both  mind  and  body.  When 
the  moral  mandates  are  reinforced  with  a  positive  will,  there  is 
absolutely  no  limit  to  their  far-reaching  influence  and  their 
great  power  for  good  in  the  regulation  of  mental  habits  and 
physical  practices. 

The  moral  mastery  of  the  individual  is  the  one  safeguard 
against  all  those  mental  tortures  and  physical  sufferings,  which 
so  certainly  come  from  conscious  sin  and  moral  depravity.  The 
moral  mastery  gives  birth  to  an  invincible  and  determined  spirit. 
The  spiritual  sovereignty  creates  a  sense  of  conscious  superiority, 
which  contributes  much  to  the  mental  peace  and  physical  health. 
Spiritual  peace  and  moral  satisfaction  carry  with  them  the 
ability  to  ignore  trifling  worries  and  the  power  to  rise  above 
our  common  everyday  harassments. 

Xo  stronger  illustration  of  the  efficacy  of  the  moral  mastery 
in  the  psychic  and  physical  realms  can  be  cited  than  the  case 
of  the  habitual  drunkard,  the  dipsomaniac.  The  author  has 
seen  many  a  case  who  had  in  no  way  been  helped  by  treatment 
in  various  sanitariums  —  to  say  nothing  of  fraudulent  liquor 
cures  and  various  other  fakes  —  who  was  sobered  up  by  religious 
enthusiasm  and  kept  sober  year  after  year  by  the  moral  mastery 
of  constant  faith.  In  fact,  in  the  opinion  of  the  author,  about 
the  only  sure  cure  to  be  recommended  for  dipsomania  is  religion- 
mania. 

CULTIVATE    SELF-COXTROL 

Let  those  who  have  lost  the  power  of  self-control  become  in- 
telligent concerning  the  physiology,  anatomy,  and  hygiene  of 
the  human  nervous  system.  Read  this  book  through  again  and 
again  until  you  become  thoroughly  acquainted  with  your  emo- 
tional self.     Become  a  master  of  every  teaching  that  has  to 


TRIUMPHAXT  SELF-MASTERY  507 

do  with  self-control,  and  then  cultivate  it  like  a  farmer  cultivates 
the  soil,  and  you  will  be  sure,  sooner  or  later,  to  obtain  a 
satisfactory  harvest  yield. 

Entirely  cure  yourself  of  that  nonsensical  doctrine  that  your 
feelings  exist  separate  and  apart  from  yourself  —  from  your 
reason  and  judgment.  Such  teaching  is  the  sheerest  of  non- 
sense. There  are  no  fundamental  or  primary  feelings  which 
exist  separate  and  apart  from  your  voluntary  mental  powers. 
They  are  all  a  part  of  your  consciousness,  and  as  such  are 
subject  to  criticism  and  susceptible  of  control. 

It  is  true  that  certain  sentiments  as  well  as  fears  and  anxieties 
may  persist  in  occupying  a  place  in  your  mental  consciousness 
quite  independent  of  your  will,  which  would  immediately  cast 
them  out.  It  is  true  that  notions  may  persist  in  your  mind 
without  the  assent  of  your  reason,  but  these  lingering  doubts, 
straggling  fears,  and  pestiferous  emotions,  while  they  may 
thus  remain  in  one's  mind,  are  in  no  sense  able  to  dominate  or 
control  you.  It  is  ourselves,  our  wills,  that  should  be  in  com- 
mand and  in  control.  Never  will  we  bow  down  and  admit  that 
any  of  these  notions,  emotions,  and  passions  are  stronger  than 
we  are.  The  science  of  self-mastery  demands  that  we  shall 
unceasingly  deny  them  this  power  and  unfalteringly  challenge 
their  usurpation  of  that  place  and  function  in  human  experi- 
ence which  alone  should  be  occupied  by  a  supreme  and  sovereign 
will. 

Hear  what  Pascal  says,  that  mystical  neurasthenic,  who  wrote 
so  well  and  so  often,  though  incompletely: 

Man's  conversion  is  prevented  by  his  idleness,  his  passions,  his 
pride  —  in  a  word,  by  self-love.  We  cannot  expect  to  conquer  this 
sentiment  by  an  idea ;  a  passion  yields  only  to  a  passion. 

Yes,  truly,  a  passion  yields  only  to  a  passion,  a  sentiment 
yields  only  to  a  sentiment ;  it  could  not  be  better  put.  But 
how  did  Pascal  not  see  that  all  our  passions,  excepting  those 
that  are  purely  animal  (hunger,  thirst,  sexual  desires,  and  de- 
sire for  physical  comfort)  are  ideas  become  sentiments  by  rea- 
son of  being  imposed  upon  our  understanding ! 

This  continued  mental  culture  leads  us  not  to  liberty,  but  to 


508  WORRY  AND  NERVOUSNESS 

self-mastery;  that  is  to  say,  to  a  beneficent  slavery  in  regard  to 
the  moral  sentiments  which  are  imposed  upon  our  minds.  It  is 
here  that  one  might  speak  of  a  categoric  imperative,  not  native 
and  reduced  to  an  imperceptible  kernel  of  conscience,  but 
acquired  and  firmly  based  upon  knowledge.  In  this  noble  spirit 
of  moral  determination  the  immortal  Guyau  said:  "He  who 
does  not  act  according  as  he  thinks,  thinks  incompletely." 

THE   OPTIMUM    LIFE 

When  human  beings  are  born  into  this  world  their  work  is 
born  with  them.  That  complex  interplay  of  heredity,  environ- 
ment, and  educational  forces  has  in  accordance  with  the  laws 
of  accident  and  averages,  created  a  more  or  less  definite  range 
of  destiny  in  which  any  single  individual  may  live  and  move 
and  have  his  being;  and  it  is  one  of  the  fascinating  tasks  of  life 
to  explore  one's  range  of  possible  activities  and  ascertain  one's 
real  "optimum  of  life";  and  in  furtherance  of  this  idea,  I  can 
do  no  better  than  to  quote  Partridge,  who  says : 

The  personal  problem  can  be  expressed,  in  biological  terms,  as  a 
search  for  an  optimum  mode  of  life.  All  animals  instinctively  do 
this.  They  are  equipped  with  special  instincts  which  direct  them,  and 
they  also  profit  by  experience,  which  enables  them  to  choose  that 
mode  of  life,  and  that  habitat,  which  is,  for  them,  the  best.  They 
migrate  here  and  there,  seek  those  conditions  of  heat,  food  supply, 
and  shelter,  that  are  best  suited  to  them.  And,  as  is  the  case  with 
man,  their  adaptation  is  not  entirely  for  the  individual,  but  for  the 
offspring  and  for  the  community  to  which  they  belong.  The  day 
can  be  called  the  unit  of  life.  If  a  man  can  learn  to  live  wisely  for 
one  day,  he  can  be  said  to  have  succeeded,  in  a  great  measure,  in 
solving  his  personal  problem. 

The  optimum  day  will  differ  vastly  among  individuals,  and 
it  is  this  difference  that  indicates  the  mode  of  progress  by 
specialization.  It  is  conceivable  that  for  one,  the  only  day 
which  can  in  the  end  produce  any  practical  values  in  life,  is  a 
day  of  almost  complete  rest;  but  it  is  not  a  complete  day,  a 
unit  of  life,  unless  it  accomplishes  something,  however  little 
it  may  be,  that  represents  the  life  purpose  of  the  individual. 
For  another,  the  optimum  day  may  be  one  of  the  most  self- 


TRIUMPHANT  SELF-MASTERY  509 

forgetful  and  strenuous  activity.  For  the  great  majority,  it 
will  be  neither  of  these  extremes,  but  it  must  be  for  each  a 
day  of  maximum  fulfillment  of  purpose,  with  a  minimum  of 
waste. 

THE  CONQUEST  OF   CIVILIZATION 

The  science  of  self-mastery  demands  that  we  come  to  possess 
a  more  or  less  perfect  control  over  ourselves  in  the  presence  of 
the  complexity  and  complicated  demands  of  modern  civilized 
society.  It  demands  that  we  shall  be  able  to  mingle  with  the 
crowd  and  move  with  the  current,  or  that  we  have  the  power 
and  poise  which  shall  enable  us  to  withdraw  from  the  common 
herd  and  stand  aloof  in  our  own  conscious  completeness,  in 
no  wise  embarrassed  by  our  isolation,  or  confounded  with  being 
enforced  to  associate  only  with  ourselves. 

Man  is  a  sovereign  being  with  soul  freedom,  mental  inde- 
pendence, and  moral  option ;  but  today  our  complex  civilization 
and  highly  developed  commerce  are  rapidly  turning  men  and 
women  into  highly  specialized  intellectual  and  industrial  ma- 
chines. One  would  naturally  think  that  the  sacredness  of  the 
sovereign  individuality  which  has  been  given  to  man  would 
naturally  protect  us  against  the  slavery  of  imitation,  but  this 
is  not  so.  The  power  of  suggestion,  the  dread  of  adverse  criti- 
cism, and  the  fear  of  ridicule,  make  of  otherwise  intelligent 
men  and  women,  abject  slaves  to  the  prevailing  fashions.  Man 
has  largely  lost  sight  of  the  fact  that  diversity  of  character  and 
expression  is  the  law  of  creation.  Xo  two  leaves,  even  on  the 
same  tree,  are  exactly  alike.  The  race  is  losing  sight  of  the  fact 
that  the  supreme  duty  of  man  is  to  live  at  his  best  —  ascertain 
the  conditions  essential  thereto,  and  faithfully  adjust  his  life 
to  them. 

As  we  increase  the  complexity  of  modern  living,  it  becomes 
necessary  that  very  simple  and  hygienic  habits  should  be  gen- 
erally adopted.  It  is  highly  essential  that  men  and  women  of 
the  twentieth  century  should  give  daily  study  and  intelligent 
thought  to  the  cultivation  and  preservation  of  health.  The 
integrity  of  the  civilized  races  is  dependent  upon  getting  away 
from  the  house,  from  the  sedentary  life.    Man  is  in  every  sense 


510  WORRY  AND  NERVOUSNESS 

an  outdoor  animal,  and  sunshine  and  fresh  air  are  indispensable 
to  his  health  and  happiness.  Many  of  our  modern  maladies, 
such  as  bronchitis,  pneumonia,  catarrh,  and  tuberculosis  are 
purely  and  simply  house  diseases. 

MENTAL  MASTERY 

Self-education  and  mental  training  ought  early  to  lead  us 
to  that  place  and  power  of  moral  supremacy  which  would 
enable  us  to  suspend  sentiment  and  impulse,  to  control  the 
emotional  motives,  for  a  sufficient  length  of  time  to  allow  our 
mental  operations  to  be  calmly  reviewed  by  judgment  and  soberly 
passed  upon  by  reason.  This  is  the  sort  of  mental  self-mastery 
we  are  seeking  to  cultivate  in  our  patients  —  a  self-control  that 
will  make  them  less  open  to  suggestion,  even  autosugges- 
tion, but  more  open  to  sound  reason  and  amenable  to  sane 
judgment. 

Our  patients  are  all  the  time  telling  us  when  we  are  exhorting 
them  to  renewed  zeal  and  increased  energy  in  their  battles  to 
conquer  self:  "But,  doctor,  I  can't  do  it.  I  have  tried  it  a 
thousand  times.  I  simply  can't  help  it.  I  have  always  been 
like  this.  It's  my  temperament,  I  was  born  that  way."  And 
I  am  forced  to  admit  that  what  the  patient  is  telling  me  is 
partially  true,  but  that  is  a  matter  of  the  past.  I  am  compelled 
to  advise  them  on  this  order :  "  All  this  I  willingly  grant  you, 
but  you  overlook  the  fact  that  we  are  engaged  in  the  task  of 
creating  a  new  temperament,  we  are  at  work  changing  your 
viewpoint,  controlling  your  emotions,  creating  new  habits;  why, 
we  are  actually  modifying  your  temperament  and  slowly  chang- 
ing your  character,  and  in  time  we  shall  have  you  created  into 
a  new  personality,  you  will  hardly  know  yourself;  even  your 
friends  will  remark,  '  what  a  change  has  come  over  him,'  '  how 
different  she  is  from  what  she  used  to  be.'  " 

THE   VICTORIOUS   LIFE 

Civilized  people  have  not  yet  reached  the  place  where  they 
are  willing  to  break  away  from  that  debilitating  and  fear-ridden 
practice  of  constantly  worrying  about  what  other  people  think 
of  them.    We  are  more  or  less  victims  of  blind  and  unreasoning 


TRIUMPHANT  SELF-MASTERY  511 

prejudice;  and  prejudice  is  a  sort  of  mental  cork,  which  prevents 
good  ideas  from  entering  the  mind,  and  sometimes  also  prevents 
splendid  thoughts  escaping  therefrom. 

Self-control  is  the  great  secret  and  source  of  human  health 
and  happiness.  Study  how  properly  to  work  both  mind  and 
body,  but  also  study  the  divine  law  of  mental  rest.  Studiously 
shun  cankering  care  and  that  life  of  perpetual  anxiety  and 
suspense  to  which  so  many  are  unfortunately  addicted.  Avoid 
fear-thought  and  worry  and  all  their  mental  cousins;  and 
remember  it  is  time  to  take  a  vacation,  to  call  a  halt,  when 
you  find  you  are  dreaming  at  night  about  your  work. 

An  uncontrolled  and  explosive  temper  is  like  dynamite  to 
happiness.  A  single  fit  of  anger  is  able  to  destroy  the  tran- 
quillity of  the  mind  for  days  and  even  weeks.  The  serpent 
of  suspicion  is  a  mind  poison,  a  thing  to  be  greatly  feared  and 
constantly  shunned,  while  despondency  is  inhuman  and  unnatural 
—  every  intelligent  man  and  woman  should  maintain  perpetual 
quarantine  against  it. 

Thousands  of  women  are  rendered  exceedingly  nervous  and 
held  in  social  bondage  by  their  foolish  endeavors  to  shine  in 
society.  Thousands  of  both  men  and  women  labor  under  the 
lash  of  debts  and  mortgages  for  no  reason  other  than  that  they 
may  enjoy  the  delusions  of  luxury.  The  idea  that  one  must  have 
fine  clothes,  diamonds,  or  automobiles,  in  order  to  maintain  his 
place  in  society,  has  wrought  the  ruin  and  compassed  the  down- 
fall of  many  otherwise  intelligent  and  happy  families. 

Modern  society  is  suppressing  and  deforming  the  individuality 
of  its  devotees.  Social  usages  and  conventionalities  are  pro- 
ducing the  "  social  stereotype."  The  rising  generation  are  taught 
to  uphold  and  ape  the  customs,  habits,  and  mannerisms  of  the 
preceding  generation.  Genius,  talent,  and  personality  are  choked 
and  strangled  by  this  insane  desire  to  run  the  rising  generation 
into  our  standard  social  moulds. 

The  civilized  nations  are  rapidly  creating  false  and  arbitrary 
standards  of  taste.  Our  methods  of  living  are  becoming  increas- 
ingly extravagant,  and  all  this  results  in  producing  dissatis- 
faction and  discontent  on  "the  part  of  the  lower  classes  of 
society  when  they  are  unable  to  secure  these  material  possessions, 


512  WORRY  AND  NERVOUSNESS 

which  they  are  being  taught  to  regard  as  essential  to  happiness 
and  good  living. 

The  social  functions,  banquets,  and  other  lavish  entertain- 
ments of  modern  society  constitute  an  appalling  waste  both  of 
time  and  money.  The  energy  and  means  foolishly  and  often 
harmfully  squandered  by  one-half  of  the  world,  would,  in  a 
short  time,  result  in  educating  and  delivering  the  other  half 
from  its  intellectual  slavery  and  industrial  bondage. 

The  life  of  the  average  housewife  and  mother  is  too  often 
made  one  of  unnecessary  drudgery  and  useless  anxiety.  In  the 
modern  home  life  there  is  altogether  too  much  of  a  tendency 
to  confuse  the  tasks  which  are  secondary  in  importance  with 
those  duties  which  are  essential  and  vital.  Housekeeping  is 
made  burdensome  by  the  necessity  of  giving  attention  to  a 
hundred  trifles,  the  utter  neglect  of  which  would  in  no  wise 
interfere  with  the  happiness  and  usefulness  of  the  home  life. 
Remember  that  the  house  is  not  the  home  —  the  home  is  made 
by  the  character  and  spirit  of  the  people  who  live  in  the  house. 
Do  not  forget  the  value  of  the  porch,  the  yard,  the  garden  — 
and  the  children. 

How  long  before  otherwise  intelligent  men  and  women  will 
dare  to  recognize  the  folly  of  false  etiquette  and  the  uselessness 
of  the  extreme  demands  of  modern  civilized  society?  Instead 
of  running  our  children  into  the  stereotyped  social  mould  of  life, 
why  not  encourage  the  development  of  the  individuality  and 
temperament  of  each  child?  And  it  is  in  this  connection  that 
our  modern  stereotyped  methods  of  education  become  apparent. 
Why  should  children  be  compelled  to  pass  through  a  routine 
system  of  education,  and  allowed  to  exercise  their  talents  only 
in  certain  specified  lines?  Let  us  hope  that  the  educational 
systems  of  the  future  will  make  provision  for  the  individual 
growth  and  development  of  the  child. 

Whatever  may  be  the  vicissitudes  which  attend  us  in  the 
battle  of  life  as  regards  the  struggle  for  dollars  and  fame,  there 
is  great  satisfaction  in  the  knowledge  that  when  we  engage 
in  the  conflict  with  self  —  when  we  fight  the  good  fight  of 
faith  against  the  selfishness  of  fear  —  that  victory,  success, 
triumph,   shall   ultimately   crown   our   efforts,   if   we   but   fight 


TRIUMPHANT  SELF-MASTERY  513 

the  laws  of  our  mental 


according  to  the  "  rules  of  the  game 
and  moral  being. 


And  now  that  I  have  told  my  story,  now  that  I  must  take 
leave  of  the  reader,  it  does  not  seem  that  I  have  written  a 
book.  I  rather  feel  that  I  have  written  you,  the  reader,  a  series 
of  letters,  each  chapter  for  a  letter,  and  that  is  why  I  have 
written  in  such  a  free  and  easy  manner.  I  somehow  feel  that  I 
know  you  —  that  I  have  met  you.  Perhaps  I  have  typically,  in 
the  person  of  some  other  nervous  sufferer  who  has  passed 
through  my  hands.  At  any  rate,  I  trust  that  you  have  gathered 
this  same  spirit  as  you  have  gone  through  the  book,  chapter 
by  chapter;  and  further,  that  you  will  be  able  to  carry  out  the 
advice  and  utilize  the  information  you  have  herein  found,  if  it 
be  possible,  in  the  same  successful  manner  that  you  would 
had  it  been  given  by  me  personally  and  directly  to  you.  So 
here  is  wishing  you  success  in  your  grand  and  glorious  struggle 
to  achieve  the  mastery  of  self  and  the  conquest  of  selfishness, 
while  I  extend  to  you  my  sincerest  sympathy  for  every  failure 
you  may  make,  and  offer  you  a  helping  hand  of  courage  and 
confidence  as  you  reenter  the  arena  to  continue  the  combat 
that  will  one  day  make  of  you  a  complete  man,  a  complete 
woman,  fully  restore  you  to  that  heavenly  estate  which  repre- 
sents our  highest  destiny,  that  full  restoration  of  the  divine 
image  —  our  glorious  restitution  which  shall  proclaim  us  the 
redeemed  sons  and  daughters  of  God. 


INDEX 


Abdomen,  massage  of,  397 
Abstinence,  physical  and  mental, 

258 
Accidents,   a   cause   of   hysteria, 

Acetanilid,  ineffectiveness  of  as 
a  cure,  410 

Action,  mental,  and  physical  ex- 
ercise, the  value  of.  24 

Adenoids,  and  stuttering,  245 

Adolescence,  hysteria  during, 
224;  rest  and  relaxation  dur- 
ing, 261 ;  hygiene  in,  269 

Aerophobia,  95 

Affection,   natural,   affected,    161 

Age,  the  effect  of  worry  and, 
J2;  and  neurasthenia,  135;  hy- 
giene of  old,  271 

Agitation,  the  waste  of  nervous, 

3/1 

Agoraphobia.  97 

Air,  fresh,  and  the  mental  state, 
22\  the  poisons  of  impure, 
157;  open,  as  a  help  in  mel- 
ancholia, 240 

Aichmophobia,  95 

Alcohol,  and  drugs  in  relation 
to  blood-pressure,  112,  412; 
cause  of  neurasthenia,  155;  as 
cause  of  hysteria,  225 ;  and 
relaxation,  384 ;  necessity  of 
abstinence  from,  410;  effect 
on  the  mind.  413 

Alcoholics,  advice  to,  417 

Alcoholism,  physical  and  moral 
treatment  of,  418 

Alienist,   denned,  8 

Altitude  and  space,  dread  of,  96 

*  Americanitis,"  or  high-pres- 
sure life,    107,   116 

Ambition,  value  of  fostering, 
447;  losing  one's,  476 


Ancestral  forest  life,  racial 
mementoes  of.  2>77 

Anger,  influence  of  on  nervous 
state,  353 ;  and  body  functions, 
371  ;  and  nervous  irritation, 
371 

Animals,   fear  of,  99 

Antipirin,  ineffective  as  head- 
ache cure,   410 

Anxiety,  in  relation  to  blood- 
pressure,  112;  as  factor  in 
apoplexy  and  heartfailure,  113 

Apoplexy,  and  blood-pressure, 
113,  117 

Apparitions,      explanation      of, 

247     ... 

Appendicitis,  and  hysteria,  229 

Appetite,  development  of,  402 

Argument  vs.  persuasion  with 
patients,  320 

Aristotle  and  mental  catharsis, 
353 ;  value  of  study  of,  442 

Art  and  science,  in  nervous  hy- 
giene, 266 

Arteries,  hardened,  and  brain 
work,  115 

Arteriosclerosis,  caused  by 
worry,  114;  high  blood-pres- 
sure and,    117 

Arts  and  crafts,  remedial  value 
of,  397 

Asthenia,  mental,  161 

Asthma,  influence  of  mind  on, 
46   _ 

Aurelius,  Marcus,  on  worry,  447 

Autointoxication,  and  neuras- 
thenia, 27,  114,  150;  chronic, 
as  cause  of  hypochondria,  185 ; 
and  gastric  neurasthenia,  202; 
origin  of,  405 

Auto-psychanalysis,  427 

Auto-suggestion,  intentional,  44; 


513 


i6 


INDEX 


as  origin  of  obsessions,  87; 
as  method  of  treatment,  279, 
304 

Bad  judgment  and  disease,  440 

Barometer,   the   human,   56 

Baseball,  popularity  of,  ex- 
plained, 379;  racial  instincts 
in,  380 

Bath,  the  cold,  effective  in  rais- 
ing blood-pressure,  395;  value 
in  breaking  nicotine  habit. 
411;  electric,  Russian,  and 
Turkish,  395 ;  ocean,  395 

Baths,  various,  to  lower  blood- 
pressure,  396 

Bed,  importance  of,  and  bed- 
room, 401 

Bible,  study  of,  in  "  reading 
cure,"  451 

Biliousness  and  brain  behavior, 

25 

Billroth,  on  "  What  is  a  doc- 
tor?" 282 

Birth  marks,  18 

Blindness,  hysteric,  and  its 
cause,  49 ;  unreasonable  fear 
of,  429 

Blood,  circulation  of,  24,  37;  and 
microbes,    39;    and    emotions, 

333 

Blood-pressure,  significance  of, 
and  method  _  of  taking,  107; 
high,  and  its  effects,  108 ; 
worry,  a  cause  of  high,  109; 
fluctuations  in,  no;  and  re- 
ligious worry,  in;  high,  and 
drink,  112;  and  apoplexy  and 
heart  failure,  113;  as  affected 
by  morphine,  113;  in  arterio- 
sclerosis and  Bright's  disease. 
117;  affected  by  tobacco,  154; 
and  anger,  372 ;  means  to 
raise,  395 ;  methods  to  lower, 
396;  affected  by  alcohol,  412; 
affected   by   morphine,  419 

Blood  stream,  the,  and  the 
mind,  26 

*  Blues,"  definition  of  chronic, 
7;  a  form  of  mild  hypochon- 
dria,   235 ;    mental    occupation 


and,  238 ;  and  the  "  work 
cure,"  470 

Blushing  and  mind  concentra- 
tion, 318 

Bock,    Dr.,    on    tea    and    coffee, 

155 

Body,  diseases  of  the,  and  brain 
disorders,  28;  power  of  mind 
over,  33;  and  mind,  treatment 
of,  256 

Body  functions  and  anger,  371 

Body  secretions,  40 

Body  waste,  elimination  of,  and 
brain  action,  28 

"  Boogy  man,"  the,  259 

Borderland  nervous  disorders, 
10,  243 

"  Boss,"  value  of  a,  in  ''  work 
cure,"  474 

Botanv,  helpfulness  of  study  of, 
266 

Boy  scout  movement,  recrea- 
tional value  of,  376 

Brain  fag,  6,  47;  behavior  of, 
and  biliousness,  25 ;  and  dys- 
pepsia. 26;  disorders  of,  and 
body  disease,  28;  influence  of 
emotions  on.  47 ;  the  develop- 
ment of,  retarded,  250;  action 
and  breathing,  23;  and  elim- 
ination, 28;  cells,  deteriora- 
tion of,  47;  control,  120,  131, 
146;  effects  of  insufficient, 
121 ;  starvation  of,  27 ;  wan- 
dering, 160;  work,  and  hard 
arteries,  115 

Breakdown,  the  modern,  nerv- 
ous, 12 

Breathing,  deep,  and  brain  ac- 
tion. 23,  45 

Breuer,  method  of  psychother- 
apy, 351. 

Bright's  disease,  causes  of,  116, 
117;  and  neurasthenia,  135 

Bromides,  danger  of,  410 

Brontophobia,  96 

Bunge,  Von,  and  ancestral  al- 
coholism, 17 

Burbank,  Luther,  on  play,  387 

Buttermilk,  value  of,  in  com- 
batting malificent  toxins,  404 


miiiiuiiL....^ : 


IXDEX 


517 


Cabot,  Dr.,  and  four  essentials 
to  the  enjoyment  of  life,  327; 
on  a  "  good  job,''  473 

Calories,    number    of,    required, 

403 

Carbohydrates,    relation    of,    to 

alcohol,  414 
Catalepsy,  in  hysteria,  227 

Catharsis,   mental,  353 
Cats,  fear  of,  99 

Causes,  common,  of  worry  and 
nervousness,  63;  moral,  of 
worry,  70;  physical,  of  neuras- 
thenia, 144;  sociological  and 
occupational,  of  neurasthenia, 
146 

Cereals  and  insomnia,  404 

Cerebral  insufficiency,  hysteria 
due  to,  222 

Character,  and  hypnotism,  289; 
formation  of,  and  will,  330 ; 
determination   of,   331,   344 

Cheerfulness,  influence  of,  22 ; 
and  the  muscular  system,  43 

Chess  and  checkers,  value  of,  in 
mind  training,  346 

Child,  physical  conditions  affect- 
ing health  of,  29;  and  nerv- 
ousness, 64;  treatment  of  the 
backward.  250;  care  necessary 
to  develop  healthy  nervous 
system,  258;  nervous  mechan- 
ism of,  259;  hygiene  of,  260; 
teaching  self-discipline,  316; 
and  fatigue,  382 ;  _  training 
emotions  in,  505 ;  individual 
development  of,  512 

Child  birth,  insanity  following, 
269 

Childhood,  the  age  to  teach  de- 
cision, 344 

Childless,  the.  270 

Chorea,  see  St.   Vitus'  dance 

Christian  Science,  its  use  of  will 
power,  178,  187;  and  pseudo- 
epilepsy,  250;  its  cures,  267; 
nature,  290;  founder,  290; 
why  it  is  believed,  291 ;  how 
it  works,  292;  eliminates  fear, 
293 ;  explanation  of  cures, 
294,  295,  299;  its  teaching, 
304;  healings,  362 


Christianity   and  psychotherapy, 

497 
Cigarette    habit,    treatment    of, 

411 
Circulation  and  emotion,  2>7)  un_ 

stable,  169 

Circulatory  system  and  chem- 
ical messages,  35 

Civilization,  modern,  in  relation 
to   neurasthenia,   13;   conquest 

of,  509 

Clairvoyant,  the,  and  suscepti- 
bility of  the  human  mind,  287 

Clapp,   on   the   effect   of   worry, 

n5 
Claustrophobia,  97 
Clownism,    period    of,    in    hys- 
teria, 232 
Coal  tar  products,  harm  of,  410 
Cocaine,   danger   of,   411;   effect 

of,  on  blood-pressure,  419 
Coffee,  harm  of,   155,  410 
Competition  and  will-power,  343 
Compress,  remedial  value  of  hot 
and  cold,  in  case  of  headache, 

394  ,       ^      1 

Concentration,  mental,  316;  phys- 
iology of,  317 

Condiments,  harm  of,  156,  404; 
candy  vs.,  414 

Confession,  comfort  of,  490; 
mental  relief  in,  499 

Confidence,  instilled  by  faith,  43 

Confusion,  mental,  a  leading 
symptom.  160;  how  to  over- 
come, 256 

Congeniality,  value  of,  475 

Conscience,  value  of,  as  a  moral 
guide  to  thought,  331 ;  educa- 
tion of,  332 

Consciousness,  threshold  of,  177 

Constipation,  diet  for  its  pre- 
vention, 404 

Contagion,  psychic,   309 

Conversational  method,  to  re- 
educate will,  281 

Cool-headedness,  90 

Country  vs.  city  schools,  272 

Country  population,  nervous 
disorders  among  the,  263 

Courage  and  deep  breathing,  45 

Courtney,  on  neurasthenics,   137 


5i8 


INDEX 


Cramps,    muscular,    in    hysteria, 

227 
Crane,     Dr.     Frank,     and     "  the 

practice      of      greatness      by 

words,"    308 
Credulity,  the  public,  and  fakers, 

286 
Crile,    experiments    with    brain 

cells,  47 
Crime  and  play,  388 
Criminal,  the,  and  psychasthenia, 

215;  the  born,  and  degenerate, 

339 

Crossness  and  its  remedy,  304 

Crowds,  a  cure  for  neurasthenia, 
262 

Cults,  faith-healing,  81  ;  psychic, 
275;  explanation  of  success  in 
healing,  362 

Curability,  assertion  of,  a  fac- 
tor in  psychotherapy,  282 

Cure,  of  stammering,  245 ;  of 
migraine,  249 ;  the  "  writing 
or  elimination,"  424;  the 
"  study,"  445  ;  the  "  play  or 
rest,"  458;  the  "social  serv- 
ice," 480;  the  "faith  and 
prayer,"  488 

Cures,  explanation  of  Christian 
Science,  294 

Dana,  Dr.,  on  symptoms  of  psy- 
chasthenic pain,  183 

Dancing,  the  instinct  for,  387 

Dark,  the  fear  of  the,  99 

Daydreaming,  333 

Death,  dread  of,  99,  428 

Deception,  mental,  286 

Decision,  practice  of,  342;  defi- 
nition of,  343 ;  cultivating  the 
habit  of,  345 ;  sports  and  out- 
door games  means  for  acquir- 
ing the  habit,  346 

De-concentration,  method  of 
mental,  366 

Deep  breathing,  effect  of,  on 
mind,  45 

Defectives  and  degenerates,  250 

Degenerate,  the,  and  his  tenden- 
cies, 339 

Delirium,  period  of,  in  hysteria, 
232 


Delusions,  fear  a  cause  of,  49; 
ancient  health,  80;  diagnostic, 

134 

Dementia  praecox,  206 

Depression,  causes  of  mental, 
35;  and  fear,  47;  periodic,  160; 
in  hypochondria,  235;  and  re- 
ligious influence,  428 

Depressing  literature,  the  bad 
effect  of,  446 

Dercum,  Dr.,  on  mental  healing, 
363 

Desire,  human,  a  cause  of 
worry,   54 

Despair,  and  Christ's  teachings, 
497 

Despondency,  religious,  431 

Deterioration  of  race,  causes  of 
the,  15  _ 

Determinism,  and  free  will,  338 

Diabetes,  a  cause  of,  116;  and 
neurasthenia,   135 

"  Diary  "  cure,  425  ;  the  thera- 
peutic, 424;  importance  of 
keeping  a,  426;  of  a  psychas- 
thenic, 433  _ 

Diet,  and  migraine,  249;  and 
foods,  402;  suggestions  for  a, 
404 ;   for  alcoholics,  414 

Dietetic,   fads,  the  harm  of,  402 

Digestion,  influence  of  mind  on, 
25,  40;  and  walking,  477 

Dirt,  unreasonable  dread  of,  98 

Discipline,  teaching  of,  to  chil- 
dren, 260;  the  value  of,  in 
overcoming  indecision,  348 

Discontentment,  431;  and  ex- 
travagance, 511 

Disease,  and  mind,  29 ;  and  fear, 
39;  influence  of  faith  on  in- 
fections, 39;  caused  by  worry, 
69 ;  dread  of,  98,  360 ;  a  cause 
of  neurasthenia,  149;  chronic 
and  acute,  192 ;  poisons  of,  a 
cause  of  hysteria,  225;  incur- 
able, and  good  humor,  466; 
and  the  teachings  of  Christ, 
498 

Disorders,  "borderland"  nerv- 
ous, 10;  nervous,  and  super- 
stition,   80 ;    digestive,    secre- 


IXDEX 


519 


tory,  respiratory,  and  circula- 
tory,  168 
Disposition,    eccentric,    270 
Disturbance,   sensory,   165 
Dizziness,    symptom   of    neuras- 
thenia, 163 
Dogma  vs.  drugs,  501 
Doll,  significance  of  the,  385 
Domestic  life,  262 
"Dope  fiend,''  making  of  a,  411 
Dowie,  John  Alexander,  and  his 
healing  methods,  298;  and  the 
devil,  304 
Dowieism,   296 
Drama,  and  its  healing  function, 

353 
Dread,  as  cause  of  premonitions. 

101 
Dreads,    definite,    95 ;     memory, 

and  dreams,  100;  treatment  of, 

103 

Dream,  the,  and  psychanalysis, 
9;  a  borderland  nervous  dis- 
order, 10;  effect  of  unremem- 
bered,  100;  effect  of,  on  work- 
ing capacity,  101  ;  and  premo- 
nition, 102;  reliance  to  be 
placed  on,  102 ;  psychasthenic 
state  and,  216;  apparitions, 
hallucinations  and,  247 ;  as 
disturber  of  peaceful  mind 
state,  247;  length  of,  247; 
physical  causes  of,  247;  most 
common  kinds  of,  248;  ex- 
planation of  falling  sensation 
in,  248;  accidental  character 
of,  248;  sexual  interpretation 
of,  356;  the  harmful  effect  of 
terrorizing,  on  neurasthene, 
401 

Drink,  the  craving  for,  416;  and 
the  idle  rich,  471 

Drinker,  habits  of  the  period- 
ical, 112,  413;  the  moderate. 
415;  past  and  future  of,  417; 
advice  to  the.  417 

Drudgery,  unnecessary,  of  the 
housewife.  512 

Drugless  treatment  of  pain,  420 

Drugs,  and  blood-pressure,  112; 
the  danger  of,  153;  and  hys- 
teria, 225 ;   faith  in,  to  be  dis- 


couraged, 286;  relaxation  vs., 
384;  the  necessity  of  avoiding, 
410 

Dubois.  11,  34;  on  human  desire, 
54;  on  causes  of  nervousness, 
63;  on  neurasthenia,  132;  on 
predisposition  for  neuras- 
thenia, 144;  on  mental  origin 
of  neurasthenia,  146;  on  psy- 
chasthenia,  211;  on  hysteria, 
226;  on  mental  discipline,  259; 
on  activity  of  sensory  mechan- 
ism, 277;  on  reason,  324;  on 
therapeutics  of  will-training, 
334 ;  on  home  environment, 
393;  advice  to  drinkers,  417 

Ductless  glands.  30 

Dypsomania,  the  road  to  and 
how  to  avoid,  415 

Dyspepsia,  202 ;  and  suggestion, 
292;   cause  and  cure  of,  403 

Eating,  influence  of,  on  think- 
ing, 26 

Eccentricity,  270 

Eddy,  Mrs.,  and  her  teachings, 
290,  304 ;  see  Christian  Science 

Education,  and  neurasthenia,   18 

Efficiency,  impairment  of,  by 
fatigue,  459 

Effort  and  ease,  the  results  of, 
386 

Egg-nog,   nutritive    value.   403 

Egotism,  unhealthy,  161 ;  de- 
fined, 364 

Electricity,  galvanic,  a  treat- 
ment for  neurasthenic  pains, 
186;  the  remedial  value  of, 
396  . 

Elimination,  and  brain  action, 
28 

Emotion,  uncontrolled,  36; 
power  of,  over  circulation,  37; 
harmful,  212;  and  hysteria, 
226;  and  will-power,  332;  re- 
lief of  repressed,  351 ;  sex, 
354;  physiology  of,  358;  char- 
acteristics of,  359;  and  relig- 
ious worship,  431 ;  training 
of,  505 

Emotional    equilibrium,   212 


520 


IXDEX 


Emotions,  influence  of  on  heart 
action,  37 ;  on  brain  and  nerv- 
ous system,  47 ;  James-Lange 
theory  of,  132;  the  mechanism 
of,  132;  in  psychasthenics, 
211;  the  practice  of  good, 
325;  regulating  of,  332;  in  re- 
lation to  expenditure  of 
energy,  333 

Employment,  detriments  of 
solitary,  265;  the  value  of 
suitable,  469 

Endurance,  influenced  by  mind, 
42 

Energy,  leakage  of,  88;  and 
emotion,  333 

Enjoyment  of  life,  the  four  es- 
sentials in  the,  327 

Ennui  in  neurasthenia,  122 

Environment,  and  the  neuras- 
thenic, 12;  necessity  of  whole- 
some, of  mother,  to  insure 
healthy  nervous  system  in 
child,  2S7',  handicaps  of,  393 

Epicurus,  value  of  study,  442 

Epileptoid  period,  the,  in  hys- 
teria, 232 

Epilepsy,  pseudo,  249 

Equilibrium,  emotional,  212; 
maintaining  mental,  504 

Etiquette,  false,  of  society,  512 

Eugenics,  scientific,  272 

Eurhythmies,  398 

Evolution,  a  defect  in  heredi- 
tary,  214 

Exercise,  the  relation  of,  in  re- 
gard to  mental  action,  24;  the 
value  of,  as  cure  for  hypo- 
chondriacs, 238;  harmonious, 
266;  physical,  397 

Exertion,  curative  value  of, 
469 

Exhaustion,  nervous,  see  neuras- 
thenia; definition  of,  5 

Extravagance,  neurological,  264 
Eve,    sensitiveness    of,    to   light, 
166 

Fad,  harm  of  the  dietetic,  402 ; 
the  medical  and  surgical,  406 
Failure  and  loneliness.  358 
Faintness  between   meals,  403 


Faith,  influence  of,  on  mind 
emotions  and  heart  action,  37 ; 
stimulating  effect  of,  on  cir- 
culation, 39 ;  as  factor  in  re- 
sisting infectious  diseases, 
39;  as  means  of  producing 
good  digestion,  40;  effect  of, 
on  muscular  system,  42 ;  and 
physical  and  mental  poise,  43 ; 
and  laughter,  43;  assisting 
skin  elimination,  44;  and  deep 
breathing,  45 ;  and  physical 
condition  of  brain.  47;  value 
of,  in  obtaining  refreshing 
sleep,  47 ;  and  nervous  control, 
48;  a  nerve  tonic,  48;  invigor- 
ating qualities  of,  49;  stimu- 
lating influence  of  on  appetite, 
49 ;  and  keenness  of  senses, 
49;  mental  happiness,  physical 
health,  and,  50;  an  agent  to 
normalize  blood-pressure,  109; 
as  preventive  of  high  tension, 
113;  and  electric  treatment  in 
psychasthenia,  186;  and  belief 
in  treatment  and  remedies, 
279;  helpful  influence  of  re- 
ligious, 284 ;  as  principle  in 
Christian  Science,  291  ;  and 
fear,  the  basis  of  divine  heal- 
ing cults,  296;  as  health  pro- 
ducer, 298;  in  regard  to  mys- 
teries and  miracles,  298;  and 
therapeutic  suggestion,  300; 
sincerity  of,  in  healing  treat- 
ment, 304;  as  remedy  in  over- 
coming worry,  305 ;  influence 
of,  on  body  functions,  319; 
and  reason,  remedial  value  of, 
325 ;  example  of  wrong  relig- 
ious, 432;  and  optimism,  432; 
and  Bible  study,  452;  in  pray- 
er. 496;  religious,  as  remedy 
in  nervous  sitates,  498;  the 
"force  of  life,"  499;  and 
obedience,  499;  Christian, 
highest  spiritual  force,  499; 
tremendous  power  of.  on 
mind  and  body,  500;  preven- 
tive against  soul  and  body 
maladies,  500;  and  self-mas- 
tery. 505 


IXDEX 


"  Faith-healing  "  cults,  81 
Faith  ideas  vs.  fear  ideas,  279 
Faker,    the   medical,   203 
Falling  sensation  in  dreams,  ex- 
planation of,  248 
Family,     the    psychopathic,     17; 

hygiene  of  the.  250 
Fashion,  slavery  to,  85 
Fatigue,  as  a  symptom  of  neu- 
rasthenia, 165 ;  psychasthenic, 
214;  chronic,  in  menial  hys- 
teria, 221 ;  resulting  from 
nervous  irritation.  372 ;  and 
headache,  393 ;  muscular  and 
mental.  394 ;  vs.  efficiency.  459 
Fear,  definition  of  chronic,  5 ; 
and  elevation  of  blood-pres- 
sure, 5 ;  chronic,  second  nature 
of  hypochondriac,  7;  and  our 
readers.  8;  chronic,  clas 
9;  hereditary,  19;  protecting 
child  from  morbid,  r. 
bad  breathing.  24;  and  auto- 
suggestion. 37  ;  and  heart  ac- 
tion, 2>7  \  as  depressant  on  cir- 
culation. 39;  as  productive  of 
toxins  harmful  to  Jiuman  or- 
ganism, 39;  the  effect  of,  on 
maternal  state.  40 ;  and  bad 
digestion,  40;  as  factor  in  de- 
creasing power  of  muscular 
m,  42;  the  effect  of.  on 
secretory  functions,  42 ;  ex- 
pressed in  man's  slovenly 
carriage,  43 ;  compared  with 
poison  toxins.  43;  and  muscle 
spasms.  43;  effect  of.  on  skin 
elimination,  44 ;  and  goose 
flesh,  45 ;  and  superficial 
breathing,  45 ;  the  effect  of,  on 
body  organs,  45 ;  and  cough- 
ing, 46 ;  in  regard  to  asthma 
and  hayf  ever.  47 ;  depressing 
mental  activities.  47 ;  and  un- 
natural rest.  47 ;  and  insomnia. 
48;  as  waster  of  energy,  48; 
a  leading  cause  of  neuras- 
thenia. 48 ;  and  food-desire. 
49;  influence  of,  on  senses, 
49;  as  cause  of  hysteria  blind- 
ness. 49:  and  delusions,  49; 
mental    despair,    physical    dis- 


ease, and,  50 ;  a  functional 
mind  disorder,  51  ;  and  psychic 
dyspepsia,  52 ;  moral,  a  cause 
of  worry.  53;  and  desire,  54; 
imaginary  difficulties  and.  55  ; 
of  lightning  and  similar 
phenomena.  57 ;  trifles  and, 
?j;  sexual  instincts  influenced 
by,  64 ;  physical  sensations 
and,  65  ;  self-consciousness  and 
mental  uneasiness  a  cause  of, 
66;  of  death,  70,  99;  of  old 
age,  73 ;  fads  and,  73  ;  super- 
stition and,  So;  of  open 
spaces  (agoraphobia),  87;  in- 
sistance  of  ideas  and,  87; 
spiders  and  mice  as  causes  of, 
88;  incessant  neurotic.  88;  ten- 
sion and,  91 ;  phobias  and.  95 ; 
of  altitude,  96;  of  being 
crowded,  97 ;  locomotor  ataxia 
and,  98;  hysterical  palsies  and, 
98;  of  microbes,  98;  of  in- 
sanity, 99,  152,  163,  213;  of 
animals,  99 ;  of  the  dark,  100 ; 
the  belief  in  premonitions  and, 
ici  ;  presentiment  and,  102 ; 
and  Carl  Schurz,  103 ;  treat- 
ment of,  103;  mental  discipline 
and,  104;  as  agent  to  elevate 
blood-pressure,  109;  religion 
and,  113;  exhaustive  effect  of, 
133 ;  of  committing  suicide  in 
neurasthenia,  134;  acuteness 
of,  a  gauge  for  neurasthenic 
state,  137;  chronic,  underlying 
cause  of  four  neurasthenic 
states,  160:  magnification  of, 
161;  of  fainting.  163;  cancer, 
stomach  trouble,  and  heart 
disease,  169;  unnatural  sensa- 
tions and,  175:  pain  and  acute. 
17S:  the  Mohammedans  and 
death.  179:  in  cerebral  neuras- 
thenia, 201 ;  sexual  disease 
and.  204:  of  losing  one's  posi- 
tion, 218;  in  hysteria,  22?; 
obsessions  and,  in  hypochon- 
dria. 239;  of  large  crowds. 
245 ;  tremors  and.  246 ;  stage 
fright  and.  246;  hallucinations 
and  baseless,  247;  necessity  of 


522 


INDEX 


avoiding,  in  nervous  states, 
258;  deleterious  impressions 
of,  on  child  mind,  259;  sub- 
stituting faith  for,  279,  306; 
incomplete  digestion  and,  283; 
deliverance  from,  and  Chris- 
tian Science,  291  ;  overcoming, 
by  emotion  of  faith,  293;  and 
faith,  basis  of  divine  healing 
cults,  296;  as  producer  of  dis- 
ease, 298;  indifference  to,  and 
self  ridicule,  306;  mental  con- 
fusion and,  307;  of  poisoning, 
312;  physical  functions  and, 
319;  the  practice  of  discount- 
ing, 323;  criticism  of  reason 
and,  324;  repression  of  emo- 
tions in  childhood  and,  351  ; 
exaggerated  sensations  of, 
360;  elimination  of,  by  "writ- 
ing cure."  424;  an  example  of 
overcoming,  425;  of  appearing 
in  public.  428;  example  of  ter- 
rorizing, 429;  attainment  of 
goal  and  foolish,  442;  Marcus 
Aurelius  on  reason  and,  447; 
helpful  passages  from  the 
Holy  Writ  to  overcome.  452; 
spiritual  imposition  as  pre- 
ventive of.  501  ;  of  criticism 
and  ridicule,  509 

Fechner,  on  the  intensity  of 
sleep,  170 

Fecble-mindedness,  250 

Feeling,  absence  of,  in  hysteria, 
227;   misinterpretation  of,  270 

Feet,  treatment  for  cold,  401 

Fever,  hysterical.  229 

Fire  panic  and  psychic  con- 
tagion, 310 

Fishing,  fascination  of,  379 

Food,  pure,  and  pure  thought, 
26;  reduction  of.  403 

Football,  the  popularity  of.  373 ; 
instinct   for  analyzed,  381 

Force,  lack  of,  430 

Forel,  Dr.,  14;  on  rest  and  sleep, 
265 ;  on  pleasure-seeking,  269 ; 
on  the  value  of  suggestion  in 
medicine,  301 

Forest  life,  racial  mementoes  of 
our  ancestral,   277 


Forethought  vs.  worry,  52 
Forgetfulness,  as  a  symptom  of 

hysteria,  227 
Fortune  teller,  fraud  of  the,  286 
Fraternity,    and    its    function   of 

relaxation,  siiS 
Fraud  and  fakery,  287 
Freedom  of  will,  the,  339 
Fresh  air,  and  the  mental  state, 

22 
Fretting,  61 

Freud,   on   psycho-neuroses,   283 
Functional   disorders,  and   mind 
cure,  275;   diagnosis  of  nerv- 
ous.   321  ;    as    affecting    emo- 
tions, 360 

Gallstones,  fictitious,  in  hysteria, 

229 
Galton,  Sir  Francis,  predisposed 

to  psychasthenia,  213 
Gaines  and  recreation,  377 
Gastric  juice,   production  of,  40 
Genius,    and    nervous    affliction, 

Germ  plasm,  the,  15 
Glands,  ductless,  30 
Globe-trotting  and  its  value,  268 
God,  practice  of  the  presence  of, 

502 
Golden   rule,  application  of  the, 

_ 
Golf,  restorative  power  of,  384 
Good   cheer,   valuable   effect   of, 

481 
Good  humor,  powerful  help  of, 

465 ;   an  example  of,  466 
Good  nature,  art  of,  465 
Goose-flesh,  45 
Grief,  chronic,  236 
Gross,  on  play  and  its  value,  377 

Habit,  physiology  of,  81 ;  psy- 
chology of,  82;  forming  of  a 
mental,  83 ;  tyranny  of,  83 ; 
the  nervous  rhythm  of,  91  ; 
pain,  176;  conquering  a,  339 

Habits,  nervous,  and  remedies, 
92  ;  regular,  and  their  effect  on 
migraine,  249;  regular,  a  part 
of  positive  hygiene,  258 


INDEX 


523 


Hale,  Edward  Everett,  on  worry, 

52 

Hall,  Stanley,  on  play,  377 

Hallucinations  and  fear,  49; 
analysis  of,  246 

Happiness,  constant  striving 
after,  a  cause  of  worry,  54; 
and  Christian   Science,  291 

Hayfever,  influence  of  the  mind 
on,  46 

Headache,  162,  181 ;  neuras- 
thenic, 163;  remedies  for,  164; 
hysterical,  230;  sick,  or  mi- 
graine, 248;  as  result  of 
fatigue,  and  treatment,  393 

Headache  powder,  harm  of,  410 

Healing,  mental,  276;  religious, 
287;  bogus  systems  of  divine, 
287,  296;  magnetic,  288;  the 
law  of  mental,  297 

Healing  cults,  the  success  of, 
362 

Healing  power,  faith  as,  297 

Health,  and  Christian  Science, 
291 ;  the  secret  of  happiness 
and.  511 

Health  delusions,  ancient,  80 

Health  fads,  73 

Healthy  impulses  and  sound 
thinking,  313 

Hearing  and  smelling,  disturb- 
ance of,  166 

Heart,  the  peripheral,  38 

Heart  action,  effect  of  emotions 
on  the,  37;  effect  of  drugs  on 
the,  410 

Heart  disease,  groundless  fear 
of,  169 

Heart  failure  and  blood-pres- 
sure, 113,  117 

Heart    regulation    and    fear,    45 

Heat,  regulation,  the  effect  of 
mind  on  the  body,  44;  effect 
of.  on  blood-pressure,  396 

Heat  and  cold,  sensations  of, 
45 ;  application  of,  in  head- 
aches, 395 

Hereditary    evolution,    a    defect    j 
in,  214 

Hereditary     form     of  _  neuras-    I 
thenic  states,  a  definition  of.  6 

Heredity   and   environment,    11;    i 


as  influenced  by  education,  18; 

in  hysteria,  224 
Hero,  how  to  become  a,  346 
Heroin,  harmful  effect  of,  411 
Hirsch,  on  the  influence  of  the 

mind   on   the   body   heat   reg- 
ulation, 44 
Hobby,  a,  and  the  "blues,"  238; 

and  system,  263 ;  necessity  of 

a,  271 
Home     environment,     handicaps 

of,  393 
Hope,  cultivation  of,  324 
Household,     administration     of, 

263 
Housekeeping,   burdensome,   512 
Human    interest,    the    value    of, 

483 

Hydrophobia,  pseudo-,  44 

Hydrotherapy,  treatment  by,  for 
neurasthenic  pains,  185 

Hygiene,  general,  of  the  nervous 
system,  255 ;  positive  and  neg- 
ative, 257 ;  and  natural  sleep, 
264;  and  nature  culture,  266; 
for  women,  269 ;  in  adoles- 
cence, 269;  of  old  age,  271 

Hypnotism,  in  regard  to  psycho- 
therapy, 9;  state  of,  described, 
289;  doubtful  value  of,  290; 
wrong  ideas  of  the  nature  of, 
290;  not  a  cure,  303;  Bern- 
heim  on,  334 

Hypochondria,  definition  of,  7; 
as  result  of  worry,  69;  dis- 
tinction between  melancholia 
and,  235;  symptoms  of,  237; 
treatment  of,  238 

Hvpochondriac,  pains  of  the, 
184 

Hvpochondriasis,  definition  of, 
8 

Hypocrisy,  beneficial  therapeutic, 

463 

Hysteria,  definition  of.  6,  222 ; 
in  olden  times,  221 ;  cause  of, 
222.  224;  epidemical.  225; 
symptoms  of,  226;  simulations 
of,  228;  attacks  of,  divided 
into  five  periods,  231 ;  special 
treatment  of.  232 

Hysterical  fever,  229 


5^4 


INDEX 


Ice  bag,  use  of  in  raising  blood- 
pressure,  395 

Idea  and  mind,  301 

Ideas,  uncontrolled,  121 ;  pro- 
ducing unreal  sensations 
through,  175;  regulating,  332; 
elimination  of  unhealthy,  3S3 

Idiosyncrasies,  88 

Idle  rich,  the,  471 

111  humor,  treatment  of,  481 

Illness  and  warped  judgment, 
440 

Imaginary  worry,  53 

Imagination,  power  of,  yj  \  un- 
controlled, in  hysteria,  222; 
and  "  psychic  seed  sowing," 
278 

Imitation,  epidemics  of,  309 

Immanuel  movement,  the,  296 

Immorality,  sex-teachings  as  a 
cause  of,  357 

Impersonation,  and  its  valuable 
effects,  463 

Imposters,  and  the  public  credul- 
ity, 286 

Inaction,  bane  of,  470 

Incapacity,  psychasthenia  caus- 
ing. 215 

Indecision,  general,  102;  and 
will-power,  342;  a  manacle  to 
will.  344;  and  discipline,  348 

Indigestion,  neurasthenia  as 
cause  of,  114;  treatment  of 
nervous,  202 

Industrial  precedence,  explana- 
tion of,  116;  slavery,  the  ten- 
sion of,  472 

Industry,  modern,  as  cause  of 
breakdown,  473 

Inebriety,  the  woes  of.  416; 
treatment  of.  4I7-4J9 

Infectious  diseases  influenced 
by  faith,  39;  and  neurasthenia, 

153 

Infirmity,  68 

Influence,  pre-natal,  and  birth 
marks,  18  ;  supernatural,  288  ; 
the  harmonizing,  of  play,  387; 
religious,  on  alcoholics,  419; 
religious,  in  relation  to  depres- 
sion, 429 


Injection,    a    harmless,    and    in- 
direct suggestion,  312 
Insanity,   fear  of,   152,   163;   de- 
mentia     praecox,      206;      and 
hysterical     attacks,     223 ;     fol- 
lowing   pregnancy    and    child- 
birth, 269;  and  play,  388 
Insomnia,    170;    and   muscle   re- 
laxation,    374;     and     "naps," 
401  ;  a  remedy  of,  402;  cereals, 
a  diet  that  aggravates,  404 
Instinctive  joy,  383 
Intelligence,     moral,     and     the 

church,  320 
Intercourse,  necessity  of   social, 

262;  and  the  Bible,  267 
Interest,  value  of  human,  483 
Intoxication  and  hysteria,  225 
Introspection,  psychasthenic,  216 
Irritability,  the  "day  of  rest"  a 

cure  for,  460 
Irritation  and  fatigue,  372 
Isolation  rest  cure,  the,  458 

Jack-knife,  theory  of  the,  378 

Jacoby,  Dr.,  on  psychic  vomiting, 
41  ;  on  the  training  of  emo- 
tions in  childhood,  505 

James,  Professor,  on  prayer  as 
a  therapeutic  measure,  493 

James-Lange  theory  of  emo- 
tions,   132 

Janet,  discoverer  of  psychasthe- 
nia, 210 

Jaques-Dalcroze,  gospel  of,  398 

Jealousy,  influence  of,  on  nerv- 
ous system,  353 

Jig-saw  puzzle,  cure  through 
the,  436 

Job,  afflictions  of,  192 

Job,  essentials  of  a  good,  473- 
476 

Johnson,  Samuel,  on  melancholy, 
400 

Joy,  instinctive,  383 

Kellogg,  Dr.,  contrasting  city 
and  country  in  regard  to  neu- 
rasthenia, 148 

Kenophobia,  95 

"  Kicking  habit,"  chronic,  57 

Kidney,  a  case  of  floating,  407 


INDEX 


525 


Labor,  joy  of  productive,  125 

Laughter,  value  of,  482 

Lesion,  definition  of,  8 

Life,  the  strenuous,  a  cause  of 
neurasthenia,  130;  value  of 
the  recreational,  256 ;  a  sys- 
tematic control  of  the  ^  daily, 
263 ;  four  essentials  to  the  en- 
joyment of,  327;  high-pres- 
sure, and  drugs,  413;  optimism 
of,  508;   victorious,  510 

Light,  and  sensitiveness  of  eyes, 
166 

Light-heartedness,  the  boon  of, 
482 

Literature,  depressing,  and  its 
bad  effect,  446;  value  of  un- 
exciting, 449 

Living,  careless,  14 

Living,  easy,  art  of,  326 

Loneliness,  and  nervousness,  357 

Love,  conceived  in  pain  and 
born  in  sorrow,  193;  its  mis- 
sion, 327 

Lowell,  James  Russell,  and 
hypochondria,  238 

Loyalty,  in  regard  to  work,  475 

Luxury,  delusions  of,  511 

Mania,  the  surgical,  407 
Manifestations,    mind    influence 

on   respiratory,  46;   accidental 

and  transient,  in  hysteria,  226; 

supernatural,  288 
Marcus  Aurelius,  on  worry,  447 
Marden,    and   the   handicaps    of 

worry,  59 
"  Marking "     of     children,     the, 

and  popular  superstitions,  257 
Martin,  Dr.,  and  his  experiments, 

459  ,    . 

Massage,  value  of,  in  neuras- 
thenia, 186;  and  electricity,  as 
treatment   for   nervous    states, 

396 
Mastery,  the  power  of,  474 
Materialism,  the  development  of 

scientific,  276 
Mathematics,     study_    of,     as     a 
means    of    practicing    concen- 
tration,   316;    and   poetry,   the 
use  of,  in  "  reading  cure,"  450 


Maxims    for    nervous    patients, 

313 

Mayo,  Dr.  William,  on  advisa- 
bility of  surgical  operations  on 
neurasthenics,  407 

Meat    eating,    and    neurasthenia, 

157      • 
Mechanisms    of    emotions,    the, 

132 

Medical   faker,  the,  203 

Medical  inspection  of  child,  im- 
portance of,  260 

Melancholia,  see  also  hypochon- 
dria; definition  of,  7;  and  neu- 
rasthenia, 134;  distinction  be- 
tween hypochondria  and,  235 ; 
simple,  239;  treatment  of,  240 

Memory  and  worry,  52 ;  train- 
ing of,  322;  lost,  352;  develop- 
ment of,  by  mathematics,  450 

Memory  deceptions,  and  premo- 
nitions,  102 

Memory  disorders,  treatment  of, 
321 

Memory  ghosts,  360 

Memory  loss,  in  hysteria,  228 

Mental  condition,  and  physical 
condition,  34 

Mental  control,  defective,  and 
mind  cure,  277 

Mental   deception,  286 

Mental  depression  and  causes, 
35,    47 

Mental  discipline,  259 

Mental  healing,  and  pseudo- 
epilepsy,  250;  and  mysticism, 
287;   the   law  of,   298 

Mental  influence,  the,  on  meta- 
bolism, 42;  over  special  senses, 

49 
Mental  medicine,  275 
Mental    messages,    and    nervous 

system,  36 
Mental    occupations,    to    combat 

the  "blues,"  238 
Mental  state,  and  fresh  air,  22; 

and     heart     action,     37;     and 

respiration,    45;    in    hysteria, 

222 
Mental  work   and   rest,   relative 

to  worry,  66 


526 


IXDEX 


Metabolic  poisons,  as  factor  in 
neurasthenia,    151 

Metabolism,  and  mind,  27;  men- 
tal influence  on,  42 

Metamorphosis  of  pre-natal  life, 
embryological,  and  the  nerv- 
ous system,  257 

MetchnikofT,  on  the  dread  of 
death,  99 

Method,  conversational,  of  re- 
educating will,  281 

Migraine,  or  sick  headache,  248; 
a  diet  for,  249 

Milk,  hot,  as  remedy  for  in- 
somia,  402;  dietetic  value  of 
eggs  and.  403 

Mind,  influence  of  physical 
health  on,  22 ;  digestion  in- 
fluenced by,  25;  and  blood 
stream,  26;  and  the  use  of 
drugs,  27;  the  effect  of  rest 
and  recreation  on.  28;  power 
of,  over  body,  29.  33 ;  influence 
of,  on  vital  resistance,  38;  in- 
fluence of,  on  digestion,  40; 
effect  of.  on  muscular  system, 
42;  effect  of.  on  skin,  and 
body  heat  regulation.  44 ;  in- 
fluence of,  on  asthma  and  hay- 
fever.  46;  habit  tension  of.  80; 
the  ability  of,  to  recognize 
unreal  sensations,  174;  the 
American  citizen's  peculiar, 
287 ;  and  idea,  302 ;  concentra- 
tion of.  317;  and  will-power, 
330;  the  effect  of  alcohol  on 
the.  413  ,     . 

Mind  centers,  as  affected  in 
hysteria.  224 

Mind  cure,  fraudulent,  180; 
utilized  thousands  of  years, 
275 ;  scientific.  276 

Mind  poisons,  and  oxygen,  23 

Mirror-habit,  the,  and  self- 
pity,  446 

Misophobia.  98 

Mitchell,  Weir,  on  the  fear  of 
cats.  99 

Modern  industry,  a  cause  of 
breakdown.  473 

Mohammedan,  the,  and  pain,  179 


Moll,  on  respiratory  oppression, 

46;  on  obsessions,  87 
Monotony,  and  variety,  in  one's 

work,  474 
Moods,  mastery  of,  504 
Mural    intelligence    and    church, 

320 
Morphine,    effect   of,    on   blood- 
pressure,    113;   the  danger  of, 

411,  419 
Mother    Nature,    a    good    nurse, 

368 
Moving  picture  craze,  the,  375 
Muscle  manifestations,   167 
Muscle  rigidity,  and  sleep.  374 
Muscular  cramps  in  hysteria,  227 
Muscular    system,    paralysis    in, 

231;    effect    of    mind    on,    42; 

influence  of  faith,  fear,  cheer- 
fulness on.  43 
Muscular     tension     and     motor 

nerves,  168 
Music,  and  rhythmic  order,  398; 

the  quieting  effect  of,  465 
Mystery,   effect   of,   in  Christian 

Science,  294 
Mysticism,    and   mental   healing, 

287 

Xarcotics,  necessity  of  avoiding, 
410 

Nature,  influence  of,  on  nervous 
state.  266;  elemental  forces  of, 
and  fear.  323 

Nature  study,  benefits  of.  445 

Near-neurasthenic,  the,  and  use- 
ful work.   130 

Nephritis,  diagnosed,  136 

Nerve  cells,  36;  identity  of,  un- 
changed through  life,  255 

Nerve  centers,  the  action  of,  48 

Nerve  irritants,  condiments  as, 
156 

Nerve  stamina,  conservation  of, 
256 

Nerves,  nutrition  of,  48;  the 
motor,  as  cause  of  muscular 
tension,  168 

Nervous  diseases,  differentiation 
of,  14;  caused  by  worry.  69 

Nervous    disorders,    borderland, 


IXDEX 


527 


10;     migraine,     one    of    most 
common,    249 

Nervous  disturbances,  recogni- 
tion of,  14 

Nervous  functions,  and  effect  of 
faith  and  fear,  49 

Nervous  indigestion,  treatment 
of,  202 

Nervous  prostration,  69;  and 
low  blood-pressure,   no 

Nervous  states,  summary  of,  9; 
differentiation  of,  13 

Nervous  system,  tissues  of,  16; 
and  "  mental  "  messages,  36 ; 
influence  of  emotions  on,  47; 
control  of,  48;  depletion  of, 
67;  behavior  of.  137;  a  tyrant 
of  the  body,  in  neurasthenia, 
138;  resistive  powers  of,  138; 
as  a  home  of  habit,  176;  and 
general  hygiene,  255 ;  heredity 
and  prophylaxis  in  relation  to 
the,  257;  successful  "manage- 
ment" of  the,  258;  built  up 
by  "decision,"  343;  and  jeal- 
ousy. 353_ 

Nervous  taint,  16 

Nervous  tension,  slavery  of,  84 ; 
in  relation  to  system  and 
order,  89;  and  cool-headed- 
ness.  90 

Nervousness,  common  causes  of 
worry  and,  63 ;  the  child  mind 
and.  63 ;  general,  and  diseases, 
128 

Neuralgia  and  hysteria,  227 

Neurasthene.  the,  and  his 
weapons,  308 

Neurasthenia,  definition  of.  5 : 
subclasses  of.  6;  inherited 
tendency  of.  14;  fear  in  its  re- 
lation, to,  48;  and  indigestion. 
114;  general  characteristics  of. 
128;  classification  of,  130;  ac- 
cidental or  acquired,  131 ;  the 
physiology  of,  132;  the  mech- 
anism of  emotions  and.  132: 
mistaken  for  melancholia.  134: 
the  aged  and,  135 ;  nervous 
system  in.  137;  symptoms  of. 
139;  five  kinds  of.  139;  causes 
of,  143;  world-wide.  147;  city 


and   country,    148;    poisons  as 
factors  in,  150 ;   and  nerve  ir- 
ritants,     156;     cerebral.     162; 
spinal,     164;     and     real     and 
imaginary  pain,  174;  five  spe- 
cial  forms  of.  201 ;   treatment 
of    spinal,    202;    gastric,    202; 
sexual,    203;    traumatic,    207; 
compared  with  hysteria.  222 
Neurasthenic,  the  average.  19 
Neurasthenic     factors,     heredity 
and  environment  as.  11;  pain, 
treatment  of,  185;  states,  clas- 
sification   of.    3 ;    subdivisions 
of.  4;   hereditary  form  of,  6; 
^terms.  definition  of.  4 
Neurasthenoidia,    definition    of, 
5 ;    and   ennui.    122 ;    a   typical 
case  of.  123;  remedial  methods 
for,  124;  and  love,  125 
Neurologist's  advice,  a,  440 
Neurotic,    nervous    hygiene    of 

the.  2~2 
Neurotic    influences,    early.    63 ; 

taint,  ancestral,  n 
Neurosis,  classification  of  func- 
tional,  3;    definition    of.   8;    a 
cure    of.    after    years    of    un- 
successful treatment.  262 
New  Thought  movement.  295 
Nicotine  habit,  breaking  of  ^the, 

Nutrition,  disordered,  25 

Obsessions,  psychic,  84;  common 
motor.  86 

Occult,  love  of  the,  286 

Occupation,  mental,  to  combat 
the  "blues,"  238;  diversity  of, 
265 ;   cure.  469 

Old  age.  ductless  glands  and,  30; 
general  hygiene  in,  271 

Operation,  necessity  for  surgi- 
cal. 406 

Optimum  mode  of  living,  the, 
256 

Orleans,  the  Maid  of.  224 

Osier,  on  blood-pressure,  114 

Osteopathy  and  pseudo-epilepsv, 
250 

Outdoor  life,  best  form  of  rec- 
reation.    268 ;     sleeping.     401 ; 


5^8 


IXDEX 


sports,  a  means  to  develop  the 
"decision   habit,"   346 
Out-of-doors,     the,     a     help     to 

hypochondriacs,   239 
Over-attention,  chronic,  217 
Over-exertion,   the    safety    mar- 
gin of,  264 
Over-feeding,  danger  of,  402 
Overwork,    mental,    116;   a   mis- 
taken case  of,  136;  a  cause  of 
neurasthenia,  144 
Oxygen,  and  mind  poisons,  23 

Pain,  imaginary,  174;  habit  or 
post-convalescent,  17G;  real 
and  unreal,  178;  curing  im- 
aginary, 179;  examples  of  neu- 
rasthenic, 181  ;  neurotic,  de- 
fined, 182;  psychasthenic,  and 
symptoms,  183 ;  the  hypochon- 
driac's, 184;  neurasthenic,  185; 
the  purpose  of,  188;  inability 
to  discern  cause  of.  189;  as 
preventative  of  indulgences, 
191;  the  results  of,  194;  the 
personal  factor  in,  196;  as 
danger  signal,  196;  hysterical 
ovarian,  227 ;  mind  concentra- 
tion and,  318;  chronic,  and 
relaxation,  375 ;  treatment  of, 
without  drugs,  420 

Palmist,  fraud  of  the.  and 
human    susceptibility,    286 

Pancreatic  juice,  35 

Panic,  fire,  and  psychic  con- 
tagion, 310;  psychic,  360 

Paralysis  agitans.  47 

Paralysis,  113;  muscular,  a  form 
of  hysteria.  231 

Partridge,  on  nervous  hygiene, 
256 ;  on  will  training.  334 ;  on 
the  optimum  mode  of  living, 
508 

Pascal,  on  self-control.  507 

Passion,  and  reason,  417 

Passional  attitudes,  in  hysteria, 
232 

Patent  medicine,  use  of.  in  neu- 
rasthenia. 157:  a  pain  killer, 
not  a  cure.  189;  habit  of,  and 
suggestion.  279;  unreasonable 
faith  in,   286 


Pathophobia,  98 

Patriotism,  therapeutic,  281 

Patrick,  Professor,  on  play  and 
recreation,  378;  on  relaxation 
and  fatigue,  382 

Pawlow,  and  his  experiments.  40 

Peculiarities,  temperamental,  a 
cause  of  worry,  55 

Pershing,  on  James-Lange 
theory  of  emotions,   132 

Personality,  hysteria  a  disorder 
in,  222;  multiple,  224;  and 
suggestion,  305 

Perspiration,  psychic  influence 
on  and  how  to  overcome  ex- 
cessive, 318;  beneficial  effect 
of,  398 

Persuasion,  a  part  of  education- 
al therapeutics,  319;  vs.  argu- 
ment, 320 

Pessimism,  the  effect  of  useful 
work  on,  272 

Phenacetin,  the  harm  of,  410 

Phenomena,  spiritualistic,  288 

Philosophers,  helpful  views  of 
ancient,  446 

Phobias,  specialized,  95 

Phobophobia,  or  the  dread  of 
dread,  96 

Phrenologist,  the,  and  the  gul- 
lible public,  286 

Physical  conditions,  affecting 
the  health  of  the  child,  29 

Physical  culture  fads,  the  use- 
lessness  of,  398 

Physical  functions,  fear,  in  re- 
g'ard  to,  319 

Physical  treatment,  outline  of, 
for  neurasthenes,  405 

Physician,  the.  of  the  future,  as 
mental  minister,  255 ;  the  pa- 
tient's faith  in  the,  and  hope. 
325;  necessary  frankness  of 
the,  440 

Play,  and  rest,  261 ;  and  its  pur- 
pose,  327,  378;  the  psychology 
of,  377;  unwholesome  sub- 
stitutes  for,  384;  distinction 
between  boys'  and  girls',  385 ; 
educational  value  of,  _  386; 
social  function  of,  387;  in  re- 
lation   to    crime,    388;     as    a 


IXDEX 


529 


cure,  460 ;  wrong  kind  of,  463 ; 
the  suggestion  element  in,  463 

Playground,  the  value  of  the 
public.  376 

Pleasure-seeking,  as  a  cause  of 
restlessness,    26S 

Pledge,  and  cure  of  inebriety, 
419 

Poetry,  helpfulness  of,  in  treat- 
ment, 451 

Poisoning,  fear  of,  and  sugges- 
tion, 312 

Poisons,  metabolic,  a  cause  of 
neurasthenia,  150;  effect  of 
fatigue,  152 

Potatoe,  value  of  the,  as  a 
staple  diet.  404 

Prayer,  and  faith  in  mental  heal- 
ing. 298;  the  value  of.  488; 
definition  of.  489;  physiology 
of,  492 ;  as  a  therapeutic  agent, 
493;  the  perversion  of.  494: 
the  harm  of,  in  given  cases, 
495 ;  as  an  inspiration  to  work, 
496 

Precedence.  industrial,  ex- 
plained, 116 

Predisposition.  in  hereditary 
neurasthenia.   143 

Pregnancy,  hygiene  of,  17 ;  in- 
sanity following.  269 

Premonitions,  origin  of,  101 

Pre-natal  influence  on  nervous 
state.  18 

Pre-natal  life,  and  nervous  sys- 
tem. 257 

Presentiments,  unfulfilled,  103 

Press,  significance  of  the  space 
devoted  to  sports  in  the  dailv. 
380 

Preyer,  and  auto-suggestion,  44, 

Prodromal     stage,     in    hysteria. 

231 
Proverbs,  perverted,  and  worrv. 

76 
Pseudo-hydrophobia.  44 
Pseudo-paralysis.  49 
Pseudo-psychotherapy.   286 
Psychalgia.  definition  of.  9 
Psychanalysis.    definition    of.   9: 

the    value    of.    282 ;    principles 


of.  336;  the  method  of,  351; 
sane,  363 

Psychasthene,  the,  born,  not 
made.  214;  history  of  a.  217 

Psychasthenia,  or  true  brain 
fag,  definition  of,  6;  an  inher- 
itance, 143;  analysis  of.  210; 
causes  of,  211;  symptoms  of. 
212;  active  and  latent  forms 
of,  213;  an  hereditary  defect, 
214;  wrong  treatment  of,  217; 
remedies  for,  218 

Psvchasthenic  pain,  svmptoms  of, 
183 

Psychatoxia,  definition  of.  9 

Psychiatry,  definition  of.  9 

Psychic,  defined.  9;  obsessions. 
84 ;  vomiting.  41 

Psychokinesia.   defined,   9 

Psychoneurosis,  defined.  9 

Psychosensory,  defined,  9 

Psychosis,  defined,  9 

Psychotherapy,  defined.  9;  evo- 
lution of.  275  ;  another  defini- 
tion of,  2-7;  pseudo-,  286;  an 
ideal  cure  of,  320;  sectarian, 
362 

Puberty,  and  its  effects,  64;  the 
influence  of,  on  the  mentality, 
204;  period  of.  coinciding  with 
appearance  of  psychasthenia, 
2:y.  stuttering,  a  phenomenon 
appearing  during  period  of, 
254 

Pulse,  affections  of  the,  169; 
intermittent,  214 

Pure  food,  and  pure  thought, 
26 

Race    deterioration,    causes    of, 

15 
Reading,    nervousness    affecting, 

165  ;  the  value  of  regular,  and 

study.  448 
Reading  course,  a  valuable.  454 
Reason,   effect   of   emotions   on, 

333:  and.  temper,  362 
Reasoning,  superficial.  161 
Recreation,    vs.    pleasure    seek- 
ing. 267 :  relaxation  and.  371 ; 

in  baseball  and   football,  379 ; 

in  fishing,  379 


530 


INDEX 


Reeducation,  method  of,  336 
Reflection  and  will-power,  333 
Regret,  uselessness  of,  361 
Regularity  and  a  daily  program, 

486 
Relaxation,  the  art  of,  261  ;  the 
practice  of,  373 ;  in  relation  to 
resistance.  375;  psychology  of, 
382 ;    unwholesome    means    to 
gain,    384;    found    in    religion 
and  society,  388 
Relics,  adoration  of,  286 
Religion,    and    the    blood-pres- 
sure,   113;    and   hysteria,   221; 
and   healing,   287;    as   a  mode 
of  relaxation,  388;  and  its  ef- 
fect   in    cases    of    alcoholics, 
419;    the    modern    dangers   to, 
500 
Religious     faith,     influence     of. 
284;   despondency.  431;   fanat- 
icism, 70;  influence.  419 
Repression,   emotional,   357 
Rescue   mission,  the  good  work 

of  the,  419 
Reserve,  emotional,  353 
Resistive  power,  the,  of  nervous 

system,   138 
Respiration  and  the  mental  state, 

45  .,         .  . 

Respiratory  manifestations,  in- 
fluence of  mind  on,  46 

Responsibilitv,  a  cause  of  worry, 
56 

Rest,  effect  of,  on  mind,  28;  the 
problem  of  tension  and,  256; 
work  and,  defined  in  reference 
to  treatment,  458;  and  over- 
feeding, 458 

"  Rest  cure  "  and  work,  400 ;  the 
isolation,  458 

Rest  day,  the  value  of  the  week- 
ly. 459 

Rheumatism,  and  worry,  no 

Rhythm,  nervous,  of  habit.  91  ; 
meaning  and  value  of,  399 

Richardson,  Dr.  B.  W.,  on  tea, 
156 

Ridicule,  good-natured,  as  a 
mind  cure.  306 

Rigidity,  muscular,  and  nervous 
tension,  91  ;  and  sleep,  374 


Rivalry,  rousing  the  instinct  of, 

386 
Romberg,      on      arteriosclerosis 

and  neurasthenia,  114 
"  Rush,''  modern  spirit  of,  373 

St.  Vitus'  dance,  simulated,  231  ; 
definition,  description,  and 
treatment  of,  243;  epidemics 
of.  309 

Safety,  the  margin  of,  in  nerv- 
ous tension,  264 

Samaritan  work,  the  value  of.  in 
curing  nervous  disorders,  482 

Satisfaction,  attainment  of 
moral,  506 

School  room,  ventilation  of  the, 
260 

Schurz.  Carl,  and  his  premoni- 
tion of  death,  103 

Science,  modern  and  Christian, 
291 

Scientific  eugenics,  272 

Seasickness,  psychic.  41 

Secretion,  effects  of.  35 

Secretions  of  body.  40;  as  af- 
fected in  hysteria,  229 

Self -analysis.  355 

Self-consciousness,  a  cause  of 
worry,    66;    and    stammering, 

245 
Self-control.    54;    modern    need 

of,  329;  cultivation  of,  506 
Self-denial,     will     power     and, 

340 
Self-depreciation,     a     factor     in 

failure  in  life.  305.  430 
Self-discipline,   the   teaching  of, 

in  Christian  Science.  293 
Self -drugging,    the    dangers    of, 

410 
Selfishness,  161 ;  in  prayer,  494 
Self-mastery,  18:  the  science  of, 

307;  triumphant.  504;   mental, 

5io 

Self-pity.  430 
Self-ridicule,  306 
Self-training,  18 

Seneca  to  Lucilius,  on  pain,  179 
Sensations,     peculiar     and     un- 
usual,  a   cause   of   worry.   65 ; 


IXDEX 


531 


unreal,  174;  minor,  in  hysteria, 
231 
Sense  disorders,   165 
Senses,     mental    influence    over 

special,  49 
Sensory  mechanism,  activity  of, 

277 
Sensory     nerves,     and     physical 

and  psychic  stimuli,  278 
Sex,  neurasthenes,  203 ;  hygiene, 
205 ;    ignorance,    in    regard   to 
sexual       neurasthenia,       205; 
cycles,    periodical,    of    women 
in  regard  to  hysteria,  226;  im- 
pulse, influence  of,  352;  emo- 
tion,   354;    madness,    present 
day,  357 
Shrines,  worship  of,  286 
Silver-nitrate,    treating   the    cig- 
arette  habit   with,   411 
Simulation  of  hysteria.  228 
Sitophobia,    dread    of    food,    or, 

96 
Skin,    action    and    brain    action, 
28;    effect    of    mind    on    heat 
regulation    and,    44;    sluggish 
circulation,   and  pale,    170 
Skull,  vibrations  of,  317 
Sleep  and  mind.  47 ;   the   inten- 
sity of.   170;   nervous   hygiene 
and     natural.     264 ;     hypnotic. 
289 ;      and      relaxation.      374 ; 
sound,  401 
Sleeping  powders,  the  harm  in. 

410 
Sleeplessness.    170;    overcoming, 
by  neutral  bath,  396;  methods 
to  allay.  461 
Smell,  deranged.  166,  227 
Social    functions,    the    waste    of 

effort   in.   512 
Social  intercourse,  necessity  of, 

262 
Somnambulism.  289 
Sorrow,  the  selfishness  of.  361 
Soul,  exercises  for  the.  308 
Sources  of  worry,  physical,  71  ; 

social,  74;   industrial.  75 
Spasms,  chronic,  and  tics.  244 
Speed,  the  racial  instinct  of.  378    i 
Spencer.  Herbert,  on  play,  t>77 


Speyr,  professor,  on  neurasthe- 
nics, 130 

Spines,  neurasthenic,  164,  201 

Spinoza,  on  intelligence  and 
will.   320 

"  Spirit  of  infirmity,"  the,  68 

Spiritism,  the  supernatural  and, 
288 

Spiritualistic  phenomena,  288 

Sport,  the  value  of,  380 

Stammering,  and  self-conscious- 
ness. 245 

Starchy  food,  preparation  of, 
403 

Stimuli,  physical  and  psychic, 
and  their  reaction,  278 

Stoicism,  religious,  500 

Stomach,  and  mind,  25;  pain  of, 
in  hysteria.  229 

Strain,  relaxation  and,  ^73',  un- 
necessary, in  sleep,  374 

Strenuous  life.  the.   130 

Study  cure,  the.  445 

Stuttering,  serious  aspects  of, 
244 :    adenoids,   the    cause    of, 

.  245  . 

Suffering,  imaginary,  85  ;  fastid- 
ious, and  imaginary  pain,  174; 
treatment  of  imaginary,  185 ; 
the  mission  of  purpose  of, 
188;  the  fellowship  of.  193; 
results  of.  194;  racial,  195; 
exaggerated,  in  hvpochondria, 
236 

Sugar  diet,  value  of  the,  for 
alcoholics.  414 

Suggestion,  a  mind  cure,  9;  in- 
fluence of,  on  muscular  sys- 
tem. 43 ;  yawning  and.  46 ; 
premonitions  and.  101  ;  power 
of,  in  hysteria.  222;  imitation 
and,  in  regard  to  hysteria,  225  ; 
effect  of,  on  stuttering,  245 ; 
period  of  menopause  and, 
269 ;  psychic  seed  sowing  and, 
27S ;  therapeutic,  279,  300 ; 
physical  treatment  and.  279; 
clairvoyants,  phrenologists, 
palmists,  etc..  and.  287;  spir- 
itism and.  288;  hypnotism  and, 
289:  dyspepsia  and,  292; 
power  of  religious.  293 ;  power 


532 


INDEX 


of,  in  divine  healing  cults, 
296;  definition  of,  300;  psy- 
chology of,  301  ;  basis  of  cura- 
tive, 303;  true  and  false,  303; 
antiquity  of  the  use  of,  303; 
Dowieism,  Christian  Science 
and,  304;  habit  of  reasoning 
and  auto-,  304;  the  influence 
of,  on  imitation,  309;  effect 
of,  on  sighing,  coughing, 
yawning,  laughing,  310;  crime 
waves  and,  310;  power  of,  in 
daily  press,  310;  behavior  of 
circulation  and,  312;  indirect, 
320;  Bernheim  on,  334;  ele- 
ment of,  in  play.  4C3 ;  power 
of   prayer   and.  492 

Suicide,  and  melancholia.  240 

Sulphonal,  harm  of.  410 

Sunshine  and  cheerfulness,  the 
influence  of.  22 

Supernatural,  the,  288 

Superstition,  in  nervous  dis- 
orders, 80;  medical,  286 

Surgery,  relation  of  neurasthe- 
nia to,  406 

Surgical   mania.  407 

Swedish   movement,   396 

Sympathy,  and  persuasion,  280 

Symptoms,  in  neurasthenia,  139; 
four  cardinal,  in  neurasthenia, 
159;  psychic,  160;  cerebral. 
162;  tired  feeling,  one  of 
chief,  in  neurasthenia.  165 ; 
digestion,  168;  psychasthenic, 
215:  in  hysteria,  226;  in  hypo- 
chondria, 237 

System,  order  and,  as  factors  in 
relieving   nervous    tension,    89 

Tango    fad   as   help   in   nervous 

states.  267 ;  recreation  and  the 

craze  of,  375 
Taste,  affections  of  the  sense  of 

166;  affections  of,  in  hysteria. 

227;   false  standards  of,  511 
Tea,    a    cause    of    neurasthenia, 

155 ;    the    harmful    effects    of, 

410 
Teachings,     ancient,     of     mind 

power  over  body,  t>3 


Telepathy,   disproving  the   exis- 
tence of,  288 
Temper,    control    of,    361 ;    and 

happiness,  511 
Temperamental      peculiarity,      a 

cause  of  worry,  55 
Tension,     mental,     and     arterial 
tension,    no;    high,   and    drug 
habit,     113;     safety     line     in 
nervous,  264 
Terms,  neurological,  8 
Terror,  elimination  of,  353 
Theater  going,  the  harm  in,  268 
Theology  worry,  431 
Therapeutic  patriotism,  281 
Therapeutics,     suggestive,     278: 
defined,   300;   educational,   316 
Thirst,  and  over-seasoned  foods, 

414 

Thought,  the  influence  of  eating 
on,  26;  wholesome,  a  part  of 
nervous  hygiene,  258;  sound, 
healthy  impulses,  313;  defec- 
tive, and  remedy,  326;  in- 
voluntary, 335 

Timidity,  a  cause  of  worry,  55 

Tobacco,  and  neurasthenia,  154; 
as  cause  of  hysteria,  225 ;  and 
relaxation,  384;  harmful  ef- 
fect of,  410;  treatment  of 
habitual  use  of,  411 

Tolerance,  480 

Tolstoy,  on  faith.  499 

Tonsils,  stuttering  resulting 
from   diseased,   245 

Touch,  affections  of  the  sense 
of.  166 

Townsend,  Colonel,  his  heart 
action,  38 

Toxins,  fatigue,  151 ;  in  neu- 
rasthenia, 153 

Tramps  as  psychasthenics,  215 

Trance  mediums,  288 

Transgressions.  physical  and 
mental,  and  results,  190 

Traumatism.  144 

Treatment  of,  alcoholism.  414, 
418;  chorea,  or  St.  Vitus' 
dance.  243 ;  cigarette  habit, 
411;  dreads,  103,  280;  gastric 
neurasthenia,  203 :  hallucina- 
tions.    247 :     headache     (neu- 


INDEX 


533 


rasthenic),       164;       headache 
(hysterical),     230;     headache 
(general),  394;  hypochondria, 
238;    hysteria    (special),    232; 
hysteric   blindness,   49 ;    liquor 
habit,     267,     417-419;     melan- 
cholia,    240 ;     migraine,     249 ; 
near-neurasthenia,    124;    nerv- 
ous   fatigue,    394 
nervous  states — 
general,     9,     255,     392;     by 
baths,  395 ;  by  massage  and 
electricity,   396;   by  physical 
exercise,    397;    by    eurhyth- 
mies,   398;    by    work.    400; 
by   rest   and    sleep,   401  ;    by 
"  writing      cure,"     424;     by 
"  study  cure,"  445  ;  by  "  rest 
and     play     cure,"     458 ;     by 
"  work       cure,"       469 ;       by 
"social    service    cure."    4S0 ; 
bv  •'  faith  and  praver  cure." 
488 
pain.  185,  420;  pseudo-epilepsy 
(fainting  spells),  250;  pseudo- 
paralysis.    49 ;     psychasthenia, 
218;  psychic  vomiting,  41  ;  sed- 
entary habits,   477 ;    sex   emo- 
tion,   355 ;     sex    neurasthenia, 
207;   sleeplessness,  461;   stam- 
mering.    245 ;     tobacco     habit, 
411;   tremors,   246 

scientific — of    mental,    mala- 
dies   and     superstition,    81 ; 
early,    of    child,    260;    sug- 
gestion   and    physical,    279 ; 
of  reeducating  will,  281 ;  of 
psychic     disturbances,     284 ; 
Christian  Science,  292;  sub- 
terfuges  and,   301 ;   by   sug- 
gestion,  304.   311;    for   will- 
building,  336 ;  for  mental  de- 
concentration,  366;  diet  and, 
404;    daily    outline    of,    for 
nervous  states,  405 
Tremors,  voluntary  and  involun- 
tary. 246 
Triangle,   the  neurasthenic,    18 
Trifles,  magnifying  of.  57 
Trional,  harm  of,  410 


Truthfulness     of     physician     to 

patient,   302 
Tumor,  in  hysteria,  231 
Tyranny  of  habit,  83 

Uncontrolled  ideas,  121 
Unhealthy  egotism,  161 
Unhealthy  ideas,  elimination  of. 

,353 
Lnmarried,     the,     and     nervous 

states,  270 
Unnatural    sensations   and    fear. 

Lnreal    sensations    and    disease, 

*74 
Lnreasonable  dread,  98 
Unusual    sensations    and    worrv, 

65 

Vacation  and  rest,  401 

Variety   in   work,   the  value   of, 

,474 

\  asomotor  system,   influence  of 

mind  on,  318 
Ventilation   and   nervous   states. 

23.  157 
Vibration,  mechanical,  treatment 

of   pain   in   hvpochondria,   bv. 

186 
Virchow  and  hypochondria,  23S 
Vital     resistance,     influence     of 

mind  on,  38 
Vitality  and  worry,  59 
Vittoz,    Dr.,     on    concentration, 

317 
Vomiting,     psychic,     41  ;     mani- 
festations of,  in  hysteria,  229 

Walking,  curative  value  of,  477 
Walsh,  on  memory  training,  322 
Walton,  Dr.,  the  maxims  of,  313 
Watchfulness,  apprehensive,  a 
symptom  in  psychasthenia.  216 
Water-drinking,  the  effect  of.  on 

blood-pressure.  395 
Weariness,  mental,  24 
Weather,    and    worry,    56;    and 

moods,  438 
Welfare    movements,    participa- 
tion in.  as  cure.  484 
Will,     training     mind     to     obev 


534 


IXDEX 


mandates  of,  18;  mind  con- 
trol and,  69;  reason,  judgment 
and,  as  factors  in  brain  con- 
trol, 120;  neurasthenoidic  state 
and,  120;  curing  hysteria  by 
training,  232 ;  reeducation  of, 
281  ;  influence  of  hypnotism 
on,  289;  intelligence  and,  320; 
exaltation  of,  321  ;  as  the 
balance  of  mental  power,  330; 
as  character  builder,  330; 
personal  responsibility  and, 
331  ;  overpowering  emotion 
and,  32,2 ;  interest  and  enthus- 
iasm in  training,  334;  spon- 
taneity of,  335;  determinism 
and,  338;  exercising  the,  339; 
harm  in  breaking,  339 ;  neglect 
in  training,  340;  decision  and, 
342;  the  ruler  of  man.  343: 
stifling,  344;  strengthening  of, 
by  prayer,  492 ;  subordination 
of,  a  necessity  of  civilized  life, 
495;  supreme,  507 
Will  power,  stimulating  effect 
of,  16;  child  training  and 
training  of,  19;  controlling 
hunger  by,  41 ;  autosuggestion 
and,  44;  enfeebled,  in  psychas- 
thenia,  214;  loss  of,  in 
hysteria,  228;  hypnotism  and, 
290;  suggestion  and,  305;  as 
the  object  of  psychotherapy, 
307;  the  need  of  using,  319;  a 
need  of  the  hour,  329;  as 
compared  with  intellectual 
culture,  329;  reflection  and, 
333 ;  dormant.  342 ;  discontinu- 
ance of  stimulants  and,  410; 
the  moderate  drinker  and,  415 
Witchcraft  and  hysterics,  221 
Woman,  the  high-strung,  269 
Work,  and  the  near-neuras- 
thenic, 130;  importance  of 
congenial,  262;  satisfaction  in 
one's,  365 ;  well-directed,  266 ; 
the  mission  of,  327;  vs.  rest. 
400;  satisfaction  in  product  of 
one's,  475 ;  loss  of  interest  in 
one's,  476 :  prayer,  an  inspira- 
tion to,  496 


"  Work  cure,"  the,  469 

World  reformers,  85 

Worry,  definition  of,  5,  51 ; 
caused  by  unnatural  breathing, 
45 ;  keenness  of  brain  and,  47 ; 
nerve  starvation  and,  48;  a 
cause  of  disease,  50;  effect  of, 
on  memory,  52 ;  psychology 
of,  52;  causes  of,  53;  analysis 
of,  53;  the  constant  "happi- 
ness desire"  a  cause  of,  54; 
temperamental  peculiarities 
and,  55;  timidity,  a  cause  of, 
55;  responsibility  and,  56;  the 
influence  of  the  weather  on, 
56;  trifles  and,  57;  the  "kick- 
ing habit"  and,  57;  habitual, 
58;  the  handicaps  of,  58;  the 
waste  of,  60;  causing  illness, 
60;  common  causes  of  nerv- 
ousness and,  63 ;  puberty  and, 
64;  unusual  sensations  and, 
65 ;  excessive  self-conscious- 
ness and,  66;  mental  work 
and,  66 ;  infirmity,  a  cause  of, 
68;  fictitious,  69;  moral  causes 
of,  70;  religious  fanaticism 
and,  70;  physical  causes  of, 
71:  old  age  and,  72;  health 
fads  and,  73 ;  social  sources 
of,  74;  industrial  causes  of, 
75 ;  perverted  proverbs  and 
their  effect  on,  76 ;  high  blood- 
pressure  caused  by,  109;  re- 
ligious, in;  apoplexy  and 
heart  failure  induced  by,  113; 
arteriosclerosis  and,  114; 
Bright's  disease,  diabetes, 
gout,  and  rheumatism  caused 
by,  116;  overwork  and,  116; 
chronic  and  neurasthenic,  130, 
136;  fear  of  insanity  and,  163; 
work  and,  216;  hysteria  and, 
224 ;  the  overthrow  of,  305 ; 
cure  of,  306;  discounting,  323; 
reason  and,  324 ;  relaxation 
and,  388;  the  theology,  431; 
cured  by  work,  470;  in  regard 
to,  what  others  think  of  one, 
5io 


INDEX 


535 


Worship,  as  a  factor  in  the  en- 
joyment of  life,  327;  a  primi- 
tive instinct,  332;  the  natural 
desire   for,  488 

Writer's  cramp,  245 


Yawning,   the   influence   of   the 
mind  on,  46 

Zoology,    study    of,    a    help    in 

nervous  states,  266 
Zoophobia  (fear  of  animals),  99 


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